Representative, Patient Access -KSMC

Overview

Representative, Patient Access I – 12 HR

The Patient Access Representative I is a role within the Kaiser Permanente Health System environment. This position welcomes patients into the care delivery setting and initiates administrative processes that lay the groundwork for clinical care and financial documentation. The incumbent is responsible for ensuring a complete and accurate patient admission/registration and for performing related duties in accordance with organizational policies, procedures, and federal/state/regulatory requirements.

• Registration:
  Greet and register patients for various medical services in a hospital setting, including potentially 24/7 environments and high-volume areas such as the Emergency Department. Pre-register when applicable. Conduct comprehensive interviews to collect demographic information, insurance data, third-party liability information, and identify needs for financial assistance. Verify patient demographics and insurance information in compliance with CMS regulations, National Registration Standards, and regional policies.
  
  Verify eligibility and benefits prior to or upon admission using computer-based verification programs. Ensure accurate patient identification and input of insurance information and Other Coverage Information (OCI). Register all patient classes and clinical services.
• Revenue Collection:
  Determine and collect patient cost-shares and partial payments. Process payments, reconcile cash drawers, and document all activity in the system. Collect point-of-service cash from patients according to department guidelines, and refer to Financial Counselors as appropriate.
• Appointing:
  Schedule or cancel appointments as needed based on member needs and regional protocol; arrange return appointments when applicable.
• Regulatory/Organizational Compliance:
  Complete required forms and adhere to payor requirements (Medicare, Medicaid, managed care, and commercial payers). Ensure documentation and signatures are obtained; maintain compliance with HIPAA, EMTALA, and CMS guidelines. Understand Medicare Secondary Payer screening, and manage basic regulatory aspects of patient registration and liability collection.
• General Services:
  Maintain supplies, assist patients with directions and department navigation, escort patients when needed, and provide information about hospital policies and procedures. Manage system downtime records and support data gathering for reporting as needed.

• Minimum one (1) year of healthcare financial experience and minimum one (1) year in a customer service role in an office environment, or
• Minimum two (2) years of post-high school education, or a combination of education and experience.
• Per the National Agreement, current KP Coalition employees have this experience requirement waived.

• High School Diploma or GED required.

• Basic Life Support
• Medical Terminology Certification

• Must obtain Medical Terminology certification within 180 days if not already held; outside applicants must have it upon hire.
• Must obtain CPR Certification within 30 days if not already held; outside applicants must have it upon hire.
• Excellent communication skills with all types of individuals.
• Excellent organizational and written skills, flexibility, and ability to switch tasks frequently.
• Typing speed of minimum 35 WPM with high accuracy.
• Previous cash handling experience.
• Ability to operate a CRT/PC (Windows, MS Word/Excel), copier, fax, phone, and headset.
• Ability to read continuously and manage a high volume of work; working knowledge of basic medical terminology, DRGs, and common procedure terminology to determine benefits and cost estimates.
• Knowledge of Medicaid, Medicare, and other government and payer requirements; basic state and federal regulations governing healthcare encounters (HIPAA, EMTALA, etc.).
• Familiarity with automated patient care systems for admissions, registration, and basic medical records functions.

• Training to become a Certified Healthcare Access Associate (NAHAM) within 180 days of employment is preferred.
• Prior EPIC application experience preferred; prior hospital or ambulatory clinic registration experience; HFMA or NAHAM certification preferred; one year of higher education preferred.

• Entry level

• Full-time

• Health Care Provider

• Hospitals and Health Care