Patient Access Representative - MUST LIVE IN KPWA MARKET

Kaiser Permanente; Bellevue (WA); On-site; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a dedicated Patient Access Representative to join their team in Bellevue. In this pivotal role, you will be the first point of contact for patients, handling registration and account management tasks while ensuring compliance with HIPAA regulations. Your strong customer service and communication skills will be essential as you assist patients with their inquiries and navigate billing processes. This role offers an opportunity to work in a dynamic environment where your contributions will directly impact patient experiences and operational efficiency. If you are passionate about healthcare and thrive in a collaborative setting, this position is perfect for you.

Qualifications

• 1+ years in a medical office or 2+ years in a fast-paced customer service role.
• Basic PC skills and experience with electronic patient accounting systems.

Responsibilities

• Perform patient access and registration duties in EPIC, including verifying demographics.
• Manage patient accounts, including obtaining prior authorizations and processing referrals.

Skills

Customer Service Skills

Communication Skills

Organizational Skills

Problem Solving

Attention to Detail

Education

High School Diploma or GED

Tools

EPIC Practice Management

MS Windows

Electronic Patient Accounting Systems

Job description

Job Summary:

Perform general patient access and registration duties in EPIC Practice Management, such as answering telephones, making appointments, processing referrals, maintaining provider templates and appointment schedules, and verifying patient demographics and insurance coverage. Perform general patient account management duties, such as obtaining prior authorization for services, processing items in the appropriate work queues to complete registration, and entering service capture data. Ensure patient accounts and coverage structures meet Kaiser Permanente standards and billing requirements of various payors. Function as a liaison to Patient Financial Services and the Health Plan. Communicate with external government payors and employers as necessary. Work directly with patients on billing-related matters and provide fee estimates to patients for Kaiser Permanente services. May perform duties related to cash collection and depositing. Demonstrate strong customer service and communication skills. Adhere to HIPAA and patient confidentiality requirements. May act as the patient's first point of contact with Kaiser Permanente.

Essential Responsibilities:

1. Patient Access and Registration: Answer phones; Perform appointment making processes; Complete accurate patient registration, such as verification of patient demographics and payor coverage; Perform check-in, check-out, admit, and discharge tasks; Build and maintain appointing templates; Perform MyGH setup verification; Communicate with patients via multiple channels; Process internal and external referrals.
2. General Account Management: Confirm and set up payor coverage structures; Obtain prior authorization for services; Process appropriate items in the patient, claim edit, and charge review work queues; Act as liaison to Patient Financial Services and the Health Plan; Communicate with external government payors and employers as necessary; Perform manual service capture and data entry; Act as liaison to Health Information Management Coding Specialist for facility-specific coding issues; Apply account review criteria and billing guidelines in preparation for off-site billing of professional services; Provide fee estimates for KP services; Assist patients with billing questions.
3. Cash Collection and Depositing: Collect co-pays and cost shares for services; Process refunds; Perform daily cash reconciliation and reporting for retail transactions; Process daily till closeout; Prepare bank documentation, combine and reconcile deposits of cashiers in the facility.
4. Customer Service: Adhere to Kaiser Permanente behavior & appearance standards; Demonstrate strong customer service and communication skills; Treat customers with courtesy and respect; Adhere to HIPAA and patient confidentiality requirements; May act as a guide when a patient accesses Kaiser Permanente services.

Basic Qualifications:

Experience:

1. Minimum one (1) year of experience in a business office within a medical care delivery, hospital, insurance, or large contact center environment OR a minimum two (2) years of experience providing excellent customer service in a fast-paced environment.
2. Per the National Agreement, current KP Coalition employees have this experience requirement waived.

Education:

1. High School Diploma OR General Education Development (GED) required.

License, Certification, Registration:

1. N/A

Additional Requirements:

1. Experience in electronic patient accounting, scheduling, or customer information systems.
2. Basic PC skills in MS Windows environment, 10-key and typing (35 WPM).
3. Customer service skills, the ability to effectively communicate with a diverse customer base, and strong organizational skills.

Preferred Qualifications:

1. Three (3) years of additional experience in a patient care setting.
2. Use of Epic Cadence/Prelude/Resolute or other patient scheduling and accounting systems.
3. Understanding of Kaiser Permanente billing protocols and cash posting systems.
4. Familiar with medical terminology.
5. Knowledge of delivery system business operations processes, including appointing, account intake and verification, cashiering, financial interviewing, referral processing, and data entry.
6. Working knowledge of health care insurance practices and billing.
7. Knowledge of health care payer/insurer types, including state and federal workers' compensation, commercial, subrogation, self-insured, Medicare (CMS), and Medicaid (DSHS).
8. Understanding of Kaiser Permanente insurance products and benefits.
9. Proven ability to establish credibility and respect with patients.
10. Proven ability to problem solve and take initiative.
11. Ability to provide feedback and education to other staff regarding correct procedures.
12. Six (6) months experience in processing various types of billing, including workers compensation, subrogation, coordination of benefits, and private/self-pay.
13. Demonstrate a high degree of adaptability, productivity, and reliability as well as an ability to work independently in an ambiguous environment.
14. Effective interpersonal, communication, and customer service skills for both face-to-face and telephone interactions with patients, medical staff, and team members.
15. Positive, open-minded, and focused on continuous improvement.
16. Ability to learn new processes, procedures, and software programs quickly, while demonstrating attention to detail and accuracy in their daily work.
17. Vocational training in medical office procedures and billing.
18. Coursework or practical training and experience in ICD-9 and CPT coding.

COMPANY: KAISER

TITLE: Patient Access Representative - MUST LIVE IN KPWA MARKET

LOCATION: Bellevue, Washington

REQNUMBER: 1334659

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.