Patient Financial Counselor II — Payer & Eligibility Expert

Kaiser Permanente; Downey (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Kaiser Permanente in Downey, CA seeks a Financial Counselor II to provide financial counseling at the point of service, determine payer sources for self-pay accounts and verify coverage, eligibility, and pre-authorization for inpatient and outpatient services.

You will assist with MFAP applications, collect co-pays, and coordinate with social services, billing, and care coordinators, while ensuring documentation is complete and accurate.

Qualifications

• Minimum three (3) years of relevant experience in Health Care billing, collections or Financial Counseling or equivalent.
• Knowledge of government programs and alternate payer sources (Workers Compensation, TPL, COB, Commercial, etc.).
• Ability to verify coverage, eligibility and pre-authorization for services and assist with MFAP workflow.
• Excellent communication and interpersonal skills, with the ability to work independently.

Responsibilities

• Upholds Kaiser Permanente policies and procedures and determines MFAP eligibility and payment arrangements.
• Identify alternate payer linkages or potential TPL or Workers' Compensation cases; refer as appropriate.
• Verify coverage on potential COB (members) cases by calling insurance carriers.
• Assists with collection of co-pays, Medi-Cal SOC, Conversion dues, non-member deposits, etc.
• Verifies eligibility for KP Membership through government programs using online systems.
• Verify pre-authorization for services from insurance carriers for outpatient and inpatient.
• Interviews patients to obtain payer source and financial/demographic information.
• Complete and process Third Party insurance claim forms and provide reports to management.

Skills

Communication skills

Interpersonal skills

Independent work

Healthcare billing

Government programs

Alternate payer sources

Computer keyboard

Education

High School Diploma

Job description

Kaiser Permanente in Downey, CA seeks a Financial Counselor II to provide financial counseling at the point of service, determine payer sources for self-pay accounts and verify coverage, eligibility, and pre-authorization for inpatient and outpatient services.

You will assist with MFAP applications, collect co-pays, and coordinate with social services, billing, and care coordinators, while ensuring documentation is complete and accurate.