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Kaiser Permanente · 3 hours ago

Patient Financial Advisor

Redwood City, CA

Full-time

Onsite

Entry Level

2+ years exp

Kaiser Permanente is seeking a Patient Financial Advisor who will be responsible for identifying financial sponsorship for patients and determining their cost share obligations. The role involves effective communication with patients about their payment liabilities and ensuring compliance with relevant regulations.

Health CareHospitalMental HealthNon ProfitPersonal Health

Comp. & Benefits

Responsibilities

Assisting members with understanding their benefits when a cost-share is owed

Determining eligibility for private, federal, state and county program coverage for patients

Interpreting and describing provisions and requirements of applicable private, federal, state and county aid programs to patients, explaining all obligations and rights under the specific program

Gathering and analyzing all patient information pertaining to financial resources and circumstances

Obtaining treatment authorizations, as needed

Advising patients of their financial responsibilities and arranging and/or collecting payments when appropriate

Providing consultation to patients regarding referrals to outside agencies or to the Medical Financial Assistance and Discount Payment (MFAP) program, including reviewing and evaluating MFAP applications for completeness and accuracy and submitting applications on behalf of patients when appropriate

Interviewing patients regarding possible workers compensation coverage, Coordination of Benefits and/or Third Party Liability

Interacting with clinical staff to obtain all pertinent information protecting patient confidentiality while ensuring all components required for reimbursement are obtained

Perform audits to determine the accuracy and completeness of the data collected in the admitting and registration process

Ensure all required data fields for insurance verification, OSHPD reporting and claims submission are accurately completed

Collect statistical data and prepare reports, as needed

Noting all activities in the Kaiser Permanente system of record (KP HealthConnect)

Performing all or part of duties and responsibilities at the direction of department management based on appropriate needs of the department, and all other tasks and duties as assigned by supervisor

The Patient Financial Advisor works collaboratively with Hospital, Clinic, Emergency Department and Member Services personnel to create a customer friendly environment

Qualification

Medical terminologyBenefit coverage interpretationFinancial counselingComputer proficiencyCollections knowledgeInterpersonal skillsOrganizational skillsCommunication skills

Required

Twenty-four (24) months of work experience including twelve (12) months of hospital, medical office or insurance company required

High school diploma or General Education Diploma (GED) required

The Patient Financial Advisor must be capable of making decisions and working independently to accomplish all responsibilities, as well as maintain an in-depth understanding of job duties and operational changes where financial counseling decisions have significant financial and medical implications

Basic knowledge and use of computer and computer keyboard (able to pass PC skills assessment and keyboarding test [a rate of 6,000 keystrokes/hour is required to pass])

Proficient in medical terminology (able to pass KP standardized test)

Demonstrated ability to understand and interpret benefit coverage information, including KP Plans, Medi-Cal, Medicare and other insurance

Must be able to apply benefit circumstances to fee schedule quotation to determine member/patient cost share obligation (able to pass fee/benefit test)

Demonstrated ability to interact in a sensitive manner with KP patients, their families and KP staff

Knowledgeable regarding the legal requirements of collections

Ability to multitask, organize and prioritize and work independently with minimal supervision

Demonstrated knowledge of the admitting and registration processes and requirements

Effective interpersonal and communications skills

Knowledgeable regarding the impact Utilization Review, Discharge Planning, Admissions and other related departments have on reimbursement

Must be willing to work in a Labor Management Partnership environment