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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 Billing Resolution Representative-PFS

Location: Pasadena, CA Additional Locations:
Job Number: 811127 Date posted: 08/14/2019

This position is responsible for resolving North, South, and Out of Region customer's billing issues / disputes within the collections call center and research environment. Skills required include analyzing account data, research and verification utilizing multiple systems, multi tasking and communicating with internal and external customers. Also, resolves outstanding receivables through direct payment, payment negotiation, bad debt write off, revenue reversals and agency assignment for Self-Pay accounts.

Essential Functions:

- Handles high volumes of in-bound calls and meets established KP metrics and goals.
- Responds to incoming communications including correspondence, inquiries from patients, guarantors, third parties, attorneys and other KP facilities or departments regarding accounts.
- This includes timely response to grievances and other regulatory concerns.
- Follows-up and performs collection of outstanding balances on accounts.
- Makes recommendations to refer accounts to appropriate parties for issue resolution such as other Collection Teams, Member Services, MFA Unit, etc.
- Evaluates account status by utilizing manual information sources and/or KPHC work queues.
- Maintains accurate account information by updating accounts receivable systems and department databases.
- Gathers information and makes recommendations related to adjustments of uncollectible balances and processes account appropriately.
- Identifies credits balances and route accounts to appropriate work queues.
- Identifies and communicates suggestions for improving department processes, procedures and customer relations via the appropriate forums within Kaiser Permanente.
- Performs other duties as assigned.
- Complies with legal and ethical requirements to protect patient, employee and KFHP confidentiality.
- Upholds Kaiser Permanente's Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
- Ensures compliance with applicable local, state, and/or federal laws and regulations, including organization policies and procedures.
- Note: Internal PFS candidates may have job advancement opportunities via the PFS Career Ladder, and should consult with their supervisor and/or manager.

Pay Grade: 18



Basic Qualifications:
- Minimum two (2) consecutive years of customer service experience within the last four (4) years.
- Minimum two (2) consecutive years of collector or biller experience within the last four (4) years.
- The Basic Computer Literacy Assessment score must be current within one (1) year of (contact Local HR Office for testing). Must obtain passing score on the Basic Computer Literacy Assessment (passing score set at 75).
- High school diploma and/or GED.
- Basic minimum required quals OR successful completion of the PFS Career Ladder curriculum that is mapped tot that position.
License, Certification, Registration
- N/A
Additional Requirements:
- Knowledge of billing and collection rules, regulations and other pertinent payer specific requirements.
- Proficient with patient accounting and computerized collection systems and use Windows operating system and Microsoft Office Applications (WORD, EXCEL, etc.).
- Problem solving skills.
- Ability to read, write and perform mathematical computations at a high school level.
- Above average active listening, communication (verbal and written), and persuasion skills, along with exceptional customer service skills.
- Must be able to sit at a computer screen and keyboard for extended periods of time.
- Ability to lift 10 lbs.
- Ability to handle rapid and high incoming call volumes for extended periods of time and use a headset.
- Ability to work well in a team environment and within the Labor Management Partnership guidelines and effectively participate in Unit Based Teams.

Preferred Qualifications:
- Customer service experience in a call center environment preferred within a healthcare environment.

- AA degree in business, or certification in insurance billing or collections issued by an accredited institution.
- Knowledge of all health care collections lines of business.
- Multi-lingual.



- This is an on-call position, days and hours may vary.


Primary Location: California,Pasadena,East Annex - Parsons 75 N. Fair Oaks Ave. Scheduled Weekly Hours: 0 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:15 AM Working Hours End: 5:15 PM Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: United Healthcare Workers - West Job Level: Individual Contributor Job Category: Accounting, Finance and Actuarial Services Department: Patient Financial Services 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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