Description: Job Summary:
Under indirect supervision, processes insurance claims, reports and billing for compensation of patients and members for medical disability benefits; processes applications from medical/life insurance, supplemental benefits and assigned accounts; obtains background information; makes arrangements to obtain monies owing; performs other collection responsibilities as needed; abides by state collection and credit regulations; interprets and complies with state/federal regulations, laws and guidelines in reference to third party payers; processes VRs for billing; maintains current knowledge of Kaiser Health Plan benefits and policies; acts as Kaiser representative.
Essential Responsibilities:

• Expedite larger dollar accounts to ensure revenue optimization for prompt payment. Monitors to ensure all insurance balances are followed up in a timely manner. Performs accurate and timely billing of insurance claims in accourdance with policies and procedures of Maui Health and in compliance with state/federal regulations, payer health plan guidelines, and third-party payer requirements. Performs follow-up with insurance companies, agencies, and/or patients; researches and takes action as required.
• Ensures charges from Charge Description Master is accurately reflected in the patients medical records via claims edits and self-audits. Perform audits as needed for quality control and to ensure efficient follow up. Communicates and corresponds effectively with insurance carriers, intermediaries, members, doctors, outside providers and patients; provides in-service orientation to other departments/personnel; obtains complete and valid information; ensures collectability and maximum reimbursement of revenues.
• Maintains familiarity and open communication with state, federal and community agencies, insurance carriers, intermediaries and others within Kaiser organization; ensures proper and adequate exchange/interpretation of data and information; ensures maximization of payments.
• Collects monies owing for all inpatient/outpatient services rendered from third party payers, employers, patients, guarantors.
• Contacts debtor by telephone and/or correspondence; arranges for collection of monies owing; abides by state and federal collection and credit rules and regulations; schedules interviews with debtors; maintains positive customer relationships through effective communication and follow-up.
• Analyzes history of delinquent accounts; determines whether account is collectible; prepares write-off accounts.

Basic Qualifications:
Experience

• Minimum one (1) year collections or administrative experience.

Education

• High school diploma.

License, Certification, Registration

• N/A

Additional Requirements:

• 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 Qualifications:

• One (1) year experience medical insurance claims processing.
• Two (2) years collections experience in healthcare field.
• Knowledge of medical terminology, CPT-4 and ICD-9-CM coding.
• Knowledge of mainframe collections applications.
• 10-key by touch.
• Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
• Post high school coursework in accounting.

Primary Location: Hawaii,Wailuku,Maui Mem. Wili Pa Loop Building
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 04:30 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: S03|AFSCME|UNAC-UHCP-UNHCEH
Job Level: Individual Contributor
Department: WILI PA - Pat. Financial Ops & Admin - 3601
Pay Range: $21.38 - $22.58 / hour The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted.
Travel: No
Flexible: Work location is on-site at a KP location, with the flexibility to work from home. Worker location must align with Kaiser Permanente's Authorized States policy. At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
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. Submit Interest