claims processor I

Kaiser Permanente; Ontario (CA); On-site; CAD 28,000 - 45,000; Full time

Job summary

Kaiser Permanente is seeking an Occupation Health Services clerical professional to perform patient reception, scheduling, billing and records handling. The role emphasizes accuracy, customer service, and multi-tasking in a busy environment across KP Health Connect and internal systems.

Primary duties include data entry, account creation, documentation, and providing professional support to patients, employers, carriers, and providers while supporting departmental operations.

Qualifications

• Typing 35 wpm required.
• Minimum of one year clerical and customer service experience in Workers Compensation.
• Knowledge of Workers Compensation claims processing; cash handling experience.

Responsibilities

• Answer and screen incoming calls; greet patients/visitors and collect forms.
• Schedule workers' compensation appointments and manage patient records.
• Process payments and transfers; maintain KP Health Connect queues daily.

Skills

Customer service

Interpersonal skills

Multitasking

Cash handling

Education

High school diploma/GED

Tools

Health Connect

KP internal systems

Job description

Under direct supervision, Provides patient/visitor reception; check in and out; cash handling appointment scheduling; and other Occupational Health Services duties clerical duties as directed. Obtains employer/carrier information for billing/reporting purposes; contact employers/carriers to obtain authorization for treatment or report status of claims. Review of records to identify potential billing opportunities and transfer charges to appropriate account, if applicable. Enter pertinent claim information into KP internal computer systems. Ordering and photocopying medical records; temporarily cover other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems,; provides personalized and professional patient/employer/carrier services. Individual must be customer service oriented. Extensive contact with members, non-members, physicians, third party administrators/carriers and employers/clients. Must be able to provide status of claim; create patient accounts and files; Input and maintain information on all appropriate systems as utilized by Kaiser Permanente. Requires excellent interpersonal skills and the ability to multitask in a busy environment.

Essential Responsibilities

• 1. Answer and screen incoming phone calls for the department. Receives and filters messages to providers/clinicians/case managers/case coordinators through the Health Connect system and reply as appropriate. Greet patients/visitors and determine nature of visit. Handles customer inquires. Assists patients in completing required forms. Request for internal /external records. Creates accounts in the KP internal systems. Transfer charges to the appropriate KP Health Connect patient account.
• Schedule appointments for workers compensation patients. Interact with internal/external customers to schedule appointments or obtain information. Make rounds to certain internal departments to retrieve paperwork, as necessary. Consolidate or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases. Reviews subpoena requests. Review KP internal systems to ensure that duplicate visits are not captured. Complete transfer of care forms. Clear designated Health Connect work queues daily.
• Open and distribute mail to proper areas; match bills to reports and mail to carrier along with any other documentation as necessary. Type various documentation as required in our current KP systems. Prepare office supply orders. Payment and collection for OHSS services, as required. Performs other related duties as required to maintain efficient departmental operations. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the oganizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.

Job Summary

Under direct supervision, Provides patient/visitor reception; check in and out; cash handling appointment scheduling; and other Occupational Health Services duties clerical duties as directed. Obtains employer/carrier information for billing/reporting purposes; contact employers/carriers to obtain authorization for treatment or report status of claims. Review of records to identify potential billing opportunities and transfer charges to appropriate account, if applicable. Enter pertinent claim information into KP internal computer systems. Ordering and photocopying medical records; temporarily cover other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems,; provides personalized and professional patient/employer/carrier services. Individual must be customer service oriented. Extensive contact with members, non-members, physicians, third party administrators/carriers and employers/clients. Must be able to provide status of claim; create patient accounts and files; Input and maintain information on all appropriate systems as utilized by Kaiser Permanente. Requires excellent interpersonal skills and the ability to multitask in a busy environment.

Essential Responsibilities

• 1. Answer and screen incoming phone calls for the department. Receives and filters messages to providers/clinicians/case managers/case coordinators through the Health Connect system and reply as appropriate. Greet patients/visitors and determine nature of visit. Handles customer inquires. Assists patients in completing required forms. Request for internal /external records. Creates accounts in the KP internal systems. Transfer charges to the appropriate KP Health Connect patient account.
• Schedule appointments for workers compensation patients. Interact with internal/external customers to schedule appointments or obtain information. Make rounds to certain internal departments to retrieve paperwork, as necessary. Consolidate or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases. Reviews subpoena requests. Review KP internal systems to ensure that duplicate visits are not captured. Complete transfer of care forms. Clear designated Health Connect work queues daily.
• Open and distribute mail to proper areas; match bills to reports and mail to carrier along with any other documentation as necessary. Type various documentation as required in our current KP systems. Prepare office supply orders. Payment and collection for OHSS services, as required. Performs other related duties as required to maintain efficient departmental operations. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the oganizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.

Experience

• 1. Answer and screen incoming phone calls for the department. Receives and filters messages to providers/clinicians/case managers/case coordinators through the Health Connect system and reply as appropriate. Greet patients/visitors and determine nature of visit. Handles customer inquires. Assists patients in completing required forms. Request for internal /external records. Creates accounts in the KP internal systems. Transfer charges to the appropriate KP Health Connect patient account.
• Schedule appointments for workers compensation patients. Interact with internal/external customers to schedule appointments or obtain information. Make rounds to certain internal departments to retrieve paperwork, as necessary. Consolidate or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases. Reviews subpoena requests. Review KP internal systems to ensure that duplicate visits are not captured. Complete transfer of care forms. Clear designated Health Connect work queues daily.
• Open and distribute mail to proper areas; match bills to reports and mail to carrier along with any other documentation as necessary. Type various documentation as required in our current KP systems. Prepare office supply orders. Payment and collection for OHSS services, as required. Performs other related duties as required to maintain efficient departmental operations. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the oganizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.

Basic Qualifications

• Typing 35 wpm required. All testing must be completed by the end of posting period.
• Minimum of one (1) year relevant clerical and customer service experience in Workers Compensation. Successfully passed a medical terminology test.
• Knowledge of Workers Compensation claims Processing. Cash handling experience. Ability to research, summarize and communicate clearly to the public, both verbally and in writing. Ability to use computer to perform assigned duties.
• EQUIPMENT UTILIZED:
• Computer , Adding Machine, Fax Machine, Photocopier, Telephone, Typewriter

Education

• High school diploma/GED

License, Certification, Registration

• N/A

Preferred Qualifications

• Work Comp billing experience preferred.
• Booking and registration experience preferred.
• Receptionist experience preferred.

Notes

• This is a temporary position for approximately six (6) months

Primary Location

California,Ontario,Ontario - Vineyard Medical Offices - A

Scheduled Weekly Hours

40

Shift

Day

Workdays

Mon, Tue, Wed, Thu, Fri

Working Hours Start

08:30 AM

Working Hours End

05:00 PM

Job Schedule

Full-time

Job Type

Standard

Worker Location

Onsite

Employee Status

Temporary

Employee Group/Union Affiliation

B05|USW|Local 7600

Job Level

Individual Contributor

Department

Fontana Med Center - Occupational Health - 0806

Pay Range

$29.31 - $33.36 / hour

Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Travel

Yes, 50 % of the Time

Work Setting

Onsite

Worker location must align with Kaiser Permanente's Authorized States policy.

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.