Patient Billing Resolution Representation

California  ‐ Onsite
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Keywords

Description

Description
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.

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. 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.

Qualifications
Basic Qualifications:
High school diploma and/or GED.
AA degree in Business, or certification in insurance billing or collections issued by an
accredited institution, preferred.
Minimum of two (2) consecutive years of customer service experience within the last
four (4) years.
Minimum of two (2) consecutive years of collector or biller experience within the last four (4) years.
Multi-lingual preferred.
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.).
Must obtain passing score on the Windows XP assessment. The Windows XP
assessment score must be current within one (1) year (contact Local HR Office for testing).
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.
Ability to work well in a team environment and within the Labor Management
Partnership guidelines and effectively participate in Unit Based Teams.
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.
Customer service experience in a call center environment preferred within a
healthcare environment.
Above average active listening, communication (verbal and written), and persuasion
skills, along with exceptional customer service skills.
Ability to work well in a team environment and within the Labor Management
Partnership guidelines and effectively participate in Unit Based Teams.
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.
Customer service experience in a call center environment preferred within a healthcare environment.
Knowledge of all healthcare collections lines of business, preferred.

Notes:
This is a Full-time, variable position. Work hours will vary between 7:45 am to 5:45 pm.

analysing 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.

Start date
n.a
From
Enclipse Corp.
Published at
30.06.2012
Project ID:
385357
Contract type
Freelance
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