Kaiser Permanente · 3 weeks ago
Patient Accounting Representative; Full-time, Maui Health
Kaiser Permanente is a healthcare organization, and they are seeking a Patient Accounting Representative to perform billing and follow-up for hospital or professional claims. The role involves accurate submission of claims, resolving denials, and ensuring maximum reimbursement according to payer agreements.
Health CareHospitalMental HealthNon ProfitPersonal Health
Responsibilities
Performs accurate and timely billing of insurance claims in accordance with policies and procedures of Maui Health and in compliance with State/Federal regulations, payer health plan guidelines, and third-party payer requirements
Expedites larger dollar accounts to ensure revenue optimization for prompt payment
Follows up timely on payment with insurance companies, agencies, payers and/or patients; researches and takes action as required on outstanding accounts
Audit payments and appeals (as needed) to ensure Maui Health has received corrected, expected payment from payers in accordance with contract terms
Responds to patient and insurance inquiries promptly and courteously
Performs audits as needed for quality control and to ensure efficient follow up
Collects monies owing for all services rendered, including third party payers, employers, and guarantors
Document all actions into account notes
Resolves payer denials, including submission of appeals as needed
Communicates timely and appropriately with Team Lead/Supervisor to identify and resolve payer/claim submission issues
Analyzes and takes appropriate action steps according to MHS protocols
Strives to achieve targeted benchmarks and exceed collection goals for prompt account resolution
Qualification
Required
Minimum one (1) year collections or administrative experience
High school diploma
Demonstrated ability to perform diversified clerical functions and basic accounting procedures
Demonstrated ability to motivate debtors to pay
Demonstrated knowledge of and skill in adaptability, change management, conflict resolution, customer service, influence, interpersonal relations, oral communication, problem solving, teamwork, and written communication
Preferred
One (1) year experience medical insurance claims processing, demonstrating knowledge of Medicaid, Medicare, & Commercial payer requirements
An Associates Degree or Bachelors Degree in Business Administration, Finance, Accounting or Healthcare-related field may be substituted for one (1) year experience as a Patient Account Representative
Knowledge of medical terminology, CPT-4 and ICD-10-CM coding
10-key by touch
Post high school coursework in accounting
Company
Kaiser Permanente
Kaiser Permanente is a health organization that offers disease prevention, mental healthcare, and chronic disease management services.
Funding
Current Stage
Late StageTotal Funding
$7.48M2018-07-17Grant· $0.08M
2014-08-05Grant· $7.4M
Leadership Team
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