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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.

Medical Insurance Data Clerk - MHS

Location: Wailuku, HI Additional Locations:
Job Number: 874247 Date posted: 03/12/2020
Description:

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.

  • Basic Qualifications:

    Experience

  • Minimum one (1) year of data entry or related experience.

  • Education

  • High school diploma or GED.

  • 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.


  • Preferred Qualifications:

  • Post high school coursework in medical terminology and bookkeeping.

  • Knowledge of CPT coding, accounts receivable, medical terminology and medical insurance benefits.
  • Primary Location: Hawaii,Wailuku,Mem. Wili Pa Loop Building 1849 Wili Pa Lp. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:00 AM Working Hours End: 4:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: S03 Job Level: Entry Level Job Category: Accounting, Finance and Actuarial Services Department: Pat. Financial Ops & Admin 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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