Job Summary:

Monitors patient and insurance accounts receivables, in order to achieve and maintain department aging guidelines. Makes pro-active attempts, using various communication tools, to contact collectable accounts within assigned financial classes. Makes members/patients and their needs a primary focus of ones actions; develops and sustains productive member/patient relationships. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs. Builds rapport and cooperative relationship with members/patients. Considers how actions or plans will affect members; responds quickly to meet member/patient needs and resolves problems.

Essential Responsibilities:

• This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.

• Monitors patient and insurance accounts receivables, in order to achieve and maintain department aging guidelines.

• Maintains active knowledge of quarterly changes and updates to payor regulations.

• Works all accounts in assigned Work Queues per department guidelines. Performs adjustments within department guidelines.

• Makes pro-active attempts, using various communication tools, to contact collectable accounts within assigned financial classes.

• Reviews account records, by resolving issues or questions and supplying any needed available documentation in order to secure maximum payment.

• Accurately interprets and works denials, as well as Explanation of Benefits.

• Give detailed explanations of account history, accurately note account activity in appropriate places with systems of record.

• Responsible for reviewing accounts for possible legal action and/or bankruptcy notification, and initiating appropriate action.

• Reviews accounts for potential refunds, and initiates paperwork and/or documentation when appropriate.

• Receives and works correspondence within department guidelines.

• Acts as a liaison or department representative regarding billing issues.

• Provides technical and clerical support, when needed.

• Provides training as assigned to new employees as well as cross-training.

• Performs other duties as assigned by management.

  Basic Qualifications:

  Experience

• Minimum two (2) years of medical billing and two (2) years of health care collections experience required OR four (4) years of collection experience required.

  Education

• High School Diploma or General Education Development (GED) required.

  License, Certification, Registration

• N/A

  Additional Requirements:

• Must pass basic MS Word and Excel tests with 80% accuracy.

• ICD 9, CPT coding and medical terminology exposure, as they relate to collections, required.

• Knowledge of current insurance rules and regulations.

• Proven ability to research, resolve and accurately document complex billing issues.

• Proven ability communicating and explaining complex issues in writing and verbally.

• Ability to work cooperatively in a team environment.

• Must be detail oriented.

• Demonstrated customer service skills, customer focus abilities and the ability to understand Kaiser Permanente customer needs.

  Preferred Qualifications:

• N/A

COMPANY: KAISER

TITLE: PFS Collector Georgia

LOCATION: Atlanta, Georgia

REQNUMBER: 1260403

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, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.