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Medical Insurance Data Clerk

Primary Location Honolulu, Hawaii Schedule Full-time Shift Day Salary $24.37 - $27.08 / hour
Job Number 1337885 Date posted 05/21/2025
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Job Summary:

Under direct supervision, researches, extracts, codes and enters patient demographics, charges and adjustments; verifies insurance benefits; performs final billing; refers claims to insurance area as necessary; researches and reconciles payments from insurance and self-pay; verifies account balances; initiates transfers if necessary.

Essential Responsibilities:


  • Prepares source documents for Health Plan/Non-Plan Self-Pay for entry of billing information.

  • Reviews visit records, Ancillary Services and Emergency Room visit records; ensures source document includes essential information required for data entry (e.g. MR#, birthdate, address, group number, subscriber name, attending physician, date of service); researches missing information.

  • Codes CDM number of services provided; adjusts fees according to health plan benefits; applies prevailing rates for non-health plan patients.

  • Registers patient and guarantor in system; enters charges; verifies totals against source documents for all billable services, regardless of billing type.

  • Enters additional charges to patient accounts form source documents prepared by insurance clerk; performs insurance benefits maintenance; verifies proration of insurance; performs final billing; refers claims to insurance area as necessary.

  • Enters adjustments to patient accounts into computer from already prepared source documents.

  • Researches payer remittances for posting; determines patient account and proper insurance company/plan; determines contractual adjustments appropriate for insurance company/plan if underpayment or overpayment; transfers unidentified payments to suspense account; refers to supervisor or proper insurance area.

  • Posts remittances and contractual adjustments to patient account; performs accounts receivable transfer when necessary to show proper liability; verifies zero insurance balance after remittance posting; refers account to insurance area if necessary; initiates rebilling action if patient still bears liability after all insurance remittances received; verifies batch total of remittances posted or suspended.

  • Batches and files source documents for all data entry; assigns batch number for input and computer reports; verifies number and total for data entered.

  • Performs miscellaneous data entry as assigned (e.g. updating of patient information, CDM additions, statistical data entry).

  • Operates standard office equipment; maintains files and office supplies as necessary.

  • Demonstrates knowledge, skills, and abilities necessary to provide culturally sensitive care and/or service.

  • Performs other duties and accepts responsibility as assigned.
Basic Qualifications:
Experience


  • One (1) year data entry or related experience.

Education

  • High school diploma; or equivalent combination of education (lesser) & experience may be considered in lieu of requirements.
License, Certification, Registration
  • N/A
Additional Requirements:

  • Type 40 wpm.
  • 10-key by touch.
  • Demonstrated knowledge of and skill in adaptability, decision making, customer service, oral communication, problem solving, systems thinking, teamwork, and written communication.
  • Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
  • Talking to co-workers, customers, outside vendors, and on the telephone.
  • Reading, writing, speaking, understanding English.
  • Training/giving and receiving instructions.
  • Mathematical ability, attention to detail (e.g. organization, prioritization, proofing), concentration, and alertness.
Preferred Qualifications:

  • Knowledge of CPT coding, accounts receivable, medical terminology and medical insurance benefits.
  • Post high school coursework in medical terminology and bookkeeping.
Primary Location: Hawaii,Honolulu,Regional Admin Low Rise Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 07:30 AM Working Hours End: 04:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: HL5|UNITE HERE|Local 5 Job Level: Entry Level Department: Regional Administrative Office - PFS Call Cntr & Cust Svc - 1201 Pay Range: $24.37 - $27.08 / hour Travel: No

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.

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