Business Services Representative

Business Services Representative

Under indirect supervision, verifies insurance eligibility and benefits, interviews patient and/or their representative to obtain demographic and financial information, identify available payer sources and records information required for admission and/or registration; Collects deposits, and/or fees; initiates billable jacket in support of all billing activities. Explains hospital rules and regulations, assists patients in completion of required forms, generates and distributes documents/reports to appropriate departments. Collects and disburses patient valuables and provides patient information.

Essential Responsibilities:

• Upholds Kaiser Permanente's Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
• Verifies patient identification and insurance eligibility/benefits, obtains required authorizations/pre-certifications and required billing information from all identified payer sources for Medical Office/ Hospital services rendered. Interviews patients and/or representative, collects/records all required financial/demographic information, obtains required signatures, explains hospital rules and regulations, generates and distributes appropriate registration/admission documents.
• Determines payer source, and prepares billable jacket containing all financial information necessary for bill completion. Coordinates and collects required Medical Office/Hospital deposits, co-payments, professional fees, Kaiser membership dues and conversions from patient and/or representative. Identifies and makes referrals to Financial Counselors, any member or non-member having a financial obligation to Kaiser Permanente for which a clear, identifiable payer source is not known.
• Coordinates and/or prepares hospital statistics Hospital Census, and records data and/or other data required by the Medical Center or the PBS department. Generates and distributes daily census reports.
• Establishes and maintains courteous, cooperative relations when interacting with other personnel, Health Plan members and the public.
• May perform other duties as required.

Pay Grade: 11

Basic Qualifications:

• Two (2) years of experience in Admitting/Registration, Financial Counseling.
• Typing 35 WPM or as required by facility.
• Ability to demonstrate knowledge of and to utilize admission/registration systems, healthcare billing practices, health plan benefits and insurance requirements.
• Per the National Agreement, current KP Coalition employees have this experience requirement waived.

Education:

• High School Diploma/GED. Certificate of completion of a course in Medical Terminology or required within 6 months of employment.

License, Certification, Registration:

• N/A

Additional Requirements:

Preferred Qualifications:

- Bilingual preferred.

- Experience is patient admissions and insurances.

Notes:

- This is an On-Call position, days and hours may vary.

- Must be available to work 10 shifts/month, 8 hrs./shift, and minimum of 2 major holidays in a year.