Experience:
3-5 years of experience
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Employment Type:
Full time
Posted:
11/29/2019
Job Category:
Education
Financial Counselor
(This job is no longer available)
Kaiser Permanente | Riverside, CA
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Job Description

Description:

This job exists to ensure that all patients' membership status/alternative payor information is accurately identified & documented. Under indirect supervision, provides financial counsel to patients in a personal interview regarding payor sources and/or heath plan benefit. It will accomplish the following revenue enhancing & member service functions. Increase revenue through accurate & timely identification of membership status/alternative payors. Counsel patients on payment alternatives. Resolve any member/patient disputes regarding eligibility for service.

Essential Functions:

* Confidentially probes patients who have been referred by staff such as inpatients/outpatient registration, department administrators, physicians, nursing, utilization management & social workers about the nature of their problems as they may concern the ability to have services covered by an alternate payor (Non-member, Coordination of Benefits, Third Party Liability, Workers' Compensation) or issues dealing w/ membership.
* If the patient is determined to be ineligible, uses independent judgment to identify an alternate payor or identify the patient as medical indigent.
* Uses knowledge of Workers' Compensation, Commercial Insurance Plans, Third Party liability, outside agencies, & governmental regulations for government programs; patient interview & observation; analysis of financial data; & physician's notes in order to accurately identify an alternate payor.
* Skillfully probes patients about their financial status, counsels & make arrangements for direct payment, status as an indigent, potential enrollment in a government sponsored program, or direct billing to patient.
* If the patient is determined to be indigent & not be able to qualify for any governmental program, completes a KP medical Financial Assistance application & based on analysis of patient's financial information, approved medical; Financial Assistance up to $2,000 value or recommended approval to supervisor when amount exceeds $2,000.
* Determines patient's ability to pay based on analysis of patient's financial information & negotiates & approved payment arrangements based on patient's financial status.
* Provides functional guidance to the support staff & trains support staff & physicians on new/revised process.
* Acts as a patient/member advocate & uses knowledge of external & internal social service agencies to accurately refer patients to social services.
* Retrospectively reviews diagnosis & treatment records to identify potential Third Party Liability & Workers' Compensation cases.
* Refers identified cases to the Billing Department.
* Screens for potential eligibility for KP membership through Government Programs (Medi-Cal, Medicare, transition Plan, etc.) & refers to Member Services.
* Obtains pre-authorization for services from employers or other insurance carriers.
* Coordinates & collects conversion dues for KP.
* Checks patient information against update eligibility using on-line systems.
* Places telephone calls to appropriate departments (Membership Accounting, Sales & Marketing, etc.)
* Ensures that all reviewed documentation in the billable jacket or on the superbill is complete & obtains any missing or needed information.
* Promotes, ensures, & improves customer service to internal/external customers by demonstrating skills which are consistent w/ the organization's philosophy of providing extraordinary customer relations & quality service.

Basic Qualifications:

* Minimum of 2 years relevant experience (health care billing, collections) sufficient to analyze financial information to determine/negotiate financial arrangements
* Experience in reviewing & analyzing financial information to assess ability to pay required
* Experience w/ automated data bases of PC systems required
* Knowledge of workers' compensation coordination of benefits & third party liability rules & regulations
* Medical terminology & knowledge of health care billing practices required
* Knowledge of registration bill accounting & collections required
* Able to use RMIS, CARG, KPDS, OPAS & ARRS

Preferred Qualifications:

* Great organizational skills preferred.
* Excellent Customer Service preferred.
* A friendly personality goes along way with our patients and other staff members.
* Great interpersonal skills/team player.
* Clear understanding of revenue collections and ability to collect cost shares of any amount.
* Firm knowledge of health insurance plans preferred.

Notes:

* This is a temporary position for approximately three (3) - six (6) months.
* Schedule to include rotating weekends, holidays and floating within the established seniority section.

Primary Location: California,Riverside,Riverside Medical Center 10800 Magnolia Ave. Scheduled Weekly Hours: 20 Shift: Variable Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: Varies Working Hours End: Varies Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Temporary Employee Group/Union Affiliation: USWA - Local 7600 Job Level: Individual Contributor Job Category: Accounting, Finance and Actuarial Services Specialty: Finance Department: Admitting Travel: Yes, 5 % of the Time 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.

Click here for additional requirements >

About Kaiser Permanente

Company Description

Serving approximately 8.7 million members in nine states and the District of Columbia, Kaiser Permanente is America's leading nonprofit integrated health plan.

Kaiser Permanente's mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve.

Our Northern California Region provides integrated health care services to approximately 3.2 million members. Approximately 4,400 physicians of The Permanente Medical Group provide services at 20 medical centers and numerous medical offices.

Company History

Founded in 1945, Kaiser Permanente is the nation’s largest not-for-profit health plan, serving more than 8.6 million members, with headquarters in Oakland, Calif. It comprises:

  1.   • Kaiser Foundation Health Plan, Inc.

  • Kaiser Foundation Hospitals and their subsidiaries

  • The Permanente Medical Groups.

At Kaiser Permanente, physicians are responsible for medical decisions. The Permanente Medical Groups, which provide care for Kaiser Permanente members, continuously develop and refine medical practices to help ensure that care is delivered in the most efficient and effective manner possible.

Kaiser Permanente’s creation resulted from the challenge of providing Americans medical care during the Great Depression and World War II, when most people could not afford to go to a doctor. Among the innovations it has brought to U.S. health care are:

  • prepaid health plans, which spread the cost to make it more affordable

  • physician group practice to maximize their abilities to care for patients

  • a focus on preventing illness as much as on caring for the sick

  • an organized delivery system, putting as many services as possible under one roof

Mission & Values

As a health care organization in the 21st century, we have a mission--to provide quality care for our members and their families, and to contribute to the well-being of our communities.

Working Here

When you bring your career to Kaiser Permanente, the work you do directly affects the health of millions. From the business people who shape our policies, to the IT professionals enabling life-saving data, to the nurses and physicians on the front line of patient care, everyone here has a role to play in the care continuum. Knowing you have a place in that process and witnessing the outcome of the work you do is empowering. It gives you a cause to stand behind. And it makes you feel proud of the work you do every day. When people witness the impact of their contributions, they excel. Together we have the power to make a difference.

Hiring Information

The first step in beginning your career search is to look for open jobs that match your skills, qualifications, and interests. Each posting includes a description of the position and the minimum required qualifications. Once you find a position you are interested in, register for an account and provide your information for consideration online.

Benefits

As an employee, you are eligible for benefits according to your full-time/part-time status and the number of hours scheduled to work per week. Benefits may vary based on your Kaiser Permanente region, position, scheduled hours, and representation by collective bargaining or employee groups, but generally include:

  • generous vacation, holiday, and sick leave

  • medical care (including prescriptions), vision, mental health, and dental care

  • disability and life insurance coverage

  • educational opportunities and tuition reimbursement

  • employee assistance programs

  • health care, dependent care, and transit spending account options

  • retirement plans

In addition, we believe in recognizing stellar performance and sponsor a variety of programs designed to reward our skilled, innovative, caring, and committed staff.

In short, at Kaiser Permanente, we understand that there is a direct correlation between happy employees and happy members. We take pride in the compassion and dedication of our employees and find many ways to reward their hard work. In return, our employees take pride in being a part of a collaborative, professional team focused on quality, service, and care.

Honors & Awards

Kaiser Permanente of Northern California has earned an "Excellent" rating from the National Committee for Quality Assurance (NCQA)-the nation's leading reviewer of health plan quality for consumers and employers. Excellent is the top rating granted by NCQA, which reviews satisfaction surveys, preventive measures, physician credentialing, member services and improvement initiatives.*

Both our Northern and Southern California regions were the only health plans in California identified by the NCQA in its list of the best health care programs in the Pacific States. (NCQA's The State of Health Care Quality 2003)

The Joint Commission on Accreditation of Healthcare Organizations accredits all Kaiser Foundation Hospitals in California.

For the seventh straight year, no other health plan has earned higher ratings from the California Cooperative Health Reporting Initiative on more measures than Kaiser Permanente. The annual ratings measure clinical quality and member satisfaction. (CCHRI Report on Quality 2003)

Our Northern California region received more three-star "Excellent" ratings than any other health plan surveyed by California's Office of the Patient Advocate on California's Quality of Care Report Card 2003-04.

* Commercial HMO and Medicare-contracted product lines: April 2003.