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Kaiser Permanente Careers

Accounting, Actuarial & Finance

Support the Bottom Line — and the Big Picture

Create the financial strategies that affect our patients, medical centers, and future. On this team, you'll provide the strategy recommendations that drive operational and process improvement, as well as face challenging opportunities to influence the future of health care.

Patient Accounting Representative

Location: Honolulu, HI Additional Locations:
Job Number: 769537 Date posted: 03/11/2019
Under indirect supervision, processes insurance claims, reports, and billing for compensation of patients and members for medical disability benefits. Processes applications from medical/life insurance, supplemental benefits and assigned accounts. Obtains background information and makes arrangements to obtain monies owing. Performs other collection responsibilities as needed. Abides by state collection and credit regulations and interprets and complies with state/federal regulations, laws and guidelines in reference to third party payers; processes VRs for billing. Maintains current knowledge of Kaiser Health Plan benefits and policies; acts as Kaiser representative.

Essential Functions:
- Receives, reviews, & controls requests for medical information, visit records, nurse/doctor notes & other pertinent documents; verifies completeness & accuracy; ensures efficiency in processing of claims; obtains medical charts & other data pertaining to request
- Audits, abstracts, & summarizes pertinent data from patient medical records, nurse/doctor notes & other documents; processes insurance claims & reports in compliance with state/federal regulations, laws, guidelines & Kaiser Health Plan policies; obtains physician signature and/or signs as provider representative; prepares service charge letters & invoices referring to fee schedule
- Prepares & audits visit records & nurse/doctor notes using various fee schedules; prepares documents with charge description master codes, required billing coding conventions, & batch totals
- Communicates & corresponds effectively with insurance carriers, intermediaries, members, doctors, outside providers & patients; provides in-service orientation to other departments/personnel; obtains complete & valid information; ensures collectability & maximum reimbursement of revenues
- Maintains familiarity & open communication with state, federal & community agencies, insurance carriers, intermediaries & others within Kaiser organization; ensures proper & adequate exchange/interpretation of data & information; ensures maximization of payments
- Collects monies owing for all inpatient/outpatient services rendered from third party payers, employers, patients, guarantors
- Contacts debtor by telephone and/or correspondence; arranges for collection of monies owing; abides by state & federal collection & credit rules & regulations; schedules interviews with debtors; maintains positive customer relationships through effective communication & follow-up
- Analyzes history of delinquent accounts; determines whether account is collectible; prepares write-off accounts; attaches pertinent information to assist outside attorney; submits to supervisor for review; summarizes monthly write-off report
- Generates appropriate adjustments; researches documents & all other available sources to determine validity of adjustment; submits back-up to data entry for key punching function
- Documents & records on HPMS computer system all collection action taken on individual accounts; maintains tickler system to monitor promised payment
- Skip traces all mail returns; researches internal & external documents & all other sources to determine whereabouts of debtor; generates file maintenance to update patient demographics for rebilling when different address obtained
- Performs other duties & accepts responsibility as assigned
Basic Qualifications:
- One year of collections or medical insurance claims processing experience
- High school diploma
- Demonstrated ability to perform diversified clerical functions and basic accounting procedures
- Demonstrated ability to motivate debtors to pay
- Demonstrated knowledge of and skill in adaptability, change management, conflict management, customer service, influence, interpersonal relations, oral communication, problem solving, teamwork, and written communication
- 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:
- Two years of collections experience in health care field
- Post high school coursework in accounting
- Knowledge of medical terminology, CPT-4 and ICD-9-CM coding
- Knowledge of mainframe collections applications
- 10-key by touch
- Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications
Primary Location: Hawaii,Honolulu,Regional Admin Low Rise 711 Kapiolani Blvd. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon - Fri Working Hours Start: 8:00 AM Working Hours End: 4:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Temporary Employee Group/Union Affiliation: HERE-Local 5 Job Level: Individual Contributor Job Category: Accounting, Finance and Actuarial Services Department: PFS Call Cntr & Gust Svc Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

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 and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

About Accounting, Finance, & Actuarial Careers

Accounting Careers

Members of our accounting team support corporate projects and lend insight to areas such as financial reporting, tax planning and preparation, and audit management. This team also includes our audit professionals, who partner with financial and operational groups across the organization to analyze budgets and streamline procedures.

Finance Careers

Supporting critical business functions such as financial services, national Medicare finance, strategic planning, auditing, and corporate finance, our finance professionals develop the strategies that enable us to meet our financial goals.

Actuarial Careers

Applying probability and statistics to the practical problems of insurance, our actuarial team performs a variety of duties, including calculating the cost of premiums and policy values, preparing statistical studies, and forecasting financial results.

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