Service representative

Job Summary :

Acts as first point of contact for Kaiser Permanente members / patients and assists members / patients through registration process under minimal direct supervision.

Practices proper cash handling and reconciliation processes in accordance with established policies and guidelines. Member and patient needs should be the primary focus of ones actions;

develops and sustains productive member / patient relationships. Actively seeks information to understand member / patient circumstances, problems, expectations, and needs.

Establishes and builds rapport and cooperative relationships with the public / members / staff. Responds quickly to meet member / patient needs and resolve problems using good judgment.

Functionality may differ based upon operational setting.

Essential Responsibilities :

Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.

Customer Service (Greeting, navigating, instructing / educating)

Greets members / patients and provides reception services, to include directing and assisting members in navigating through the medical center.

Provides wayfinding to appropriate care locations / departments as availability allows. Provides direction and instructional guidance to patients who are unable to perform check-in services independently via KP interactive and emerging technologies.

• Provides coordination of services to address member needs related to benefits, finance and other member services utilizing available technology.
• Provides reception for designated area(s); verifies patients visit with pre- established appointment scheduling; registers patients;

verifies and selects appropriate insurance coverage including confirmation of alternate insurance, and assists members at designated KP interactive and emerging technologies and on all Kaiser Permanente sponsored electronic devices and technologies.

• Provides patient information to family members, following established patient confidentiality guidelines.
• Provides patients with assistance and education with regard to the use of KP interactive and emerging technologies.
• Demonstrates flexibility when addressing various member issues and needs related to operations and member services.
• Follows KP Service Standards.

General Job Functions :

• Schedules member and non-member appointments and follow-ups, by telephone, mail, electronically or in person utilizing Kaiser Permanentes computer systems as directed by provider or pre-established protocol.
• Ensures current schedules are accurate, makes authorized changes as appropriate.
• Verifies members benefits, notifies member of applicable cost share and updates patients demographics information to include all patient registration and billing information.

Escalate any issues as appropriate.

• Directs patients to waiting areas. Obtains relevant information to determine priority appointment time / date, confirms appointment changes due to cancellations and notifies patients of available alternate times, schedules / registers for follow up appointments, tests and procedures.
• Answers calls and relays messages to staff.
• Distributes questionnaires, various medical / authorization / insurance forms, patient communication materials, and completes statistical reports as requested.
• Provides patient instructions as appropriate.
• Performs related clerical duties as required, such as direct booking, copying, etc.
• Performs related clerical duties in support of Clinic Strategic Goals and Proactive Office Encounters.
• Provides telephone reception for designated area by screening and referring incoming calls to appropriate staff; takes and relays messages;

gives out general or procedural information.

• May assist in orienting new employees.
• Maintains courteous relations with patients and staff.
• Follows Labor Management Principals.
• May perform other duties as required.

Cash Handling

• Determines and collects appropriate payments for services and products (where applicable) rendered as required per health plan coverage and the established fee schedule;
• informs member of account balance information; collects and documents in the computer system receipt of a variety of financial and non-financial forms and reviews with members as appropriate;

directs patients to waiting areas.

Carries out appropriate cash control procedures of balancing total revenue received with computer system cash drawer to ensure accuracy;

completes closing process in the computer system and deposits daily revenue securely in safe.

Additional duties for Service Representatives in Optical Services to include :

• Coordinates eyewear for delivery to patient.
• Communicates with the Optical Lab, Contact Lens Distribution Center, and other Optical Centers to manage eyewear order logistics
• Assists with inventory control procedures

Additional duties for Service Representative in Laboratory to include :

• Explains proper specimen collection to members, rejects unsatisfactory specimens.

Last updated : 2024-11-07