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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.

Financial Counselor (TEMPORARY)

Location: Ontario, CA Additional Locations:
Job Number: 819319 Date posted: 08/29/2019
Description:
This job exists to ensure that all patients' membership status/alternative payor information is accurately identified & documented. Under indirect supervision, provides financial counsel to patients in a personal interview regarding payor sources and/or heath plan benefit. It will accomplish the following revenue enhancing & member service functions. Increase revenue through accurate & timely identification of membership status/alternative payors. Counsel patients on payment alternatives. Resolve any member/patient disputes regarding eligibility for service.

Essential Functions:
- Confidentially probes patients who have been referred by staff such as inpatients/outpatient registration, department administrators, physicians, nursing, utilization management & social workers about the nature of their problems as they may concern the ability to have services covered by an alternate payor (Non-member, Coordination of Benefits, Third Party Liability, Workers' Compensation) or issues dealing w/ membership.
- If the patient is determined to be ineligible, uses independent judgment to identify an alternate payor or identify the patient as medical indigent.
- Uses knowledge of Workers' Compensation, Commercial Insurance Plans, Third Party liability, outside agencies, & governmental regulations for government programs; patient interview & observation; analysis of financial data; & physician's notes in order to accurately identify an alternate payor.
- Skillfully probes patients about their financial status, counsels & make arrangements for direct payment, status as an indigent, potential enrollment in a government sponsored program, or direct billing to patient.
- If the patient is determined to be indigent & not be able to qualify for any governmental program, completes a KP medical Financial Assistance application & based on analysis of patient's financial information, approved medical; Financial Assistance up to $2,000 value or recommended approval to supervisor when amount exceeds $2,000.
- Determines patient's ability to pay based on analysis of patient's financial information & negotiates & approved payment arrangements based on patient's financial status.
- Provides functional guidance to the support staff & trains support staff & physicians on new/revised process.
- Acts as a patient/member advocate & uses knowledge of external & internal social service agencies to accurately refer patients to social services.
- Retrospectively reviews diagnosis & treatment records to identify potential Third Party Liability & Workers' Compensation cases.
- Refers identified cases to the Billing Department.
- Screens for potential eligibility for KP membership through Government Programs (Medi-Cal, Medicare, transition Plan, etc.) & refers to Member Services.
- Obtains pre-authorization for services from employers or other insurance carriers.
- Coordinates & collects conversion dues for KP.
- Checks patient information against update eligibility using on-line systems.
- Places telephone calls to appropriate departments (Membership Accounting, Sales & Marketing, etc.)
- Ensures that all reviewed documentation in the billable jacket or on the superbill is complete & obtains any missing or needed information.
- Promotes, ensures, & improves customer service to internal/external customers by demonstrating skills which are consistent w/ the organization's philosophy of providing extraordinary customer relations & quality service.
Basic Qualifications:
- Minimum of 2 years relevant experience (health care billing, collections) sufficient to analyze financial information to determine/negotiate financial arrangements
- Experience in reviewing & analyzing financial information to assess ability to pay required
- Experience w/ automated data bases of PC systems required
- Knowledge of workers' compensation coordination of benefits & third party liability rules & regulations
- Medical terminology & knowledge of health care billing practices required
- Knowledge of registration bill accounting & collections required
- Able to use RMIS, CARG, KPDS, OPAS & ARRS

 

Notes:

Schedule to include all shifts, rotating weekends, holidays, and floating within the established seniority section.

This is a temporary position for approximately 6 months

 



Primary Location: California,Ontario,Ontario - Vineyard Medical Center - H 2295 South V Scheduled Weekly Hours: 20 Shift: Variable Workdays: Variable Working Hours Start: Variable Working Hours End: Variable Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Temporary Employee Group/Union Affiliation: USWA - Local 7600 Job Level: Individual Contributor Job Category: Accounting, Finance and Actuarial Services Specialty: Finance Department: Admitting 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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