Revenue Cycle / Patient Accounts Specialist III
Primary Location Pasadena, California
Worker Location Flexible
Job Number 1352985 Date posted 05/01/2025
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Description:
Job Summary:
Independently applies and adheres to legal, compliance, and reporting standards; takes inquiries from providers, members, attorneys, and other stakeholders and conducts research to answer moderately complex and non-standard questions. Identifies education training needs and delivers training to address those needs. Identifies and escalates recommendations for process improvement, system updates, and successful execution of projects. Monitors and tracks vendor performance.
Essential Responsibilities:
- Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
- Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
- Ensures their own work is in compliance by: adhering to federal and state laws, and applicable compliance standards.
- Ensures accurate patient accounts by: taking inquires from providers, members, attorneys, and other insurance personnel to research and answer standard and nonstandard billing questions.
- Reviews high-risk denials to determine the root cause by: leveraging financial clearance and correct coverage, coding, or billing knowledge and analyzing denials to finds trends and reporting findings while partners with other teams to make recommendations for the senior managers.
- Facilitates performance management initiatives by: following general application of standard strategies to monitor quality and productivity metrics associated with operational improvement to ensure the teams work meet established performance levels and analyzes data and experiential information to generate standard and nonstandard report outs and presents the information to revenue cycle leadership to make next-step determinations. following general application of standard strategies to monitor vendor performance of collections, coding services, Medi-Cal, systems, coverage validation, income verification.
- Facilitates process management initiatives by: using comprehensive foundational knowledge of business practices to coordinate with operations managers, process improvement, IT, clinicians, and health plan managers to plan process improvement projects and identify business needs while also contributing to plans to translate business needs into project requirements that are then used to develop project specifications and action plans.
- Facilitates project management initiatives by: contributes to project execution and management efforts by collaborating with stakeholders across teams to ensure the project is successfully executed and project-based changes are implemented, with guidance.
- Facilitates regulatory reporting by: learning, researching, and applying regulation standards while also reviewing the accuracy of own work and making corrections.
- Facilitates systems management initiatives by: integrating new systems processes with the teams work while providing recommendations for new updates such as testing, validating, and partnering to setup work ques (e.g., flush the system), partnering with other entities.
- Facilitates training by: providing targeted training to peers based on approved curriculum.
- Develops training materials by: using comprehensive foundational knowledge of business practices to identify education and training requirements that reflect revenue cycle changes to develop strategic training content.
Minimum Qualifications:
- Associates degree in health care administration, business administration, or related field. OR Minimum one (1) years of experience in data analytics, merchant services , clinic/hospital operations, merchant services, banking, health care billing and collections, or relevant experience.
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): N/A
Preferred Qualifications:
- Two (2) years of experience in business/process analysis.
- One (1) year of experience developing and delivering training modules.
Primary Location: California,Pasadena,West Annex - Parsons
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee
Job Level: Individual Contributor
Specialty: Revenue Cycle / Patient Accounts
Department: Parsons East Annex - Payment Posting - 0808
Pay Range: $81100 - $104830 / year
Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: No
Flexible: Work location is on-site at a KP location, with the flexibility to work from home.
Worker location must align with Kaiser Permanente's Authorized States policy.
At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
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.
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.
Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.
Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.
Submit Interest
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.
For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:
