Under the direct supervision of the Outside Services Manager, is responsible to order ambulance transportation, verify trips billed by transportation vendors, process invoices, and verify payment responsibility, as defined in the Health Plan Service Agreement. Input and maintain Ambulance Utilization Reporting System (AURS). Solves problems and makes recommendations for improvements; uses specialty department software; interacts effectively with members, co-workers and clients. Essential Functio... more details
Description:
Under the direct supervision of the Outside Services Manager, is responsible to order ambulance transportation, verify trips billed by transportation vendors, process invoices, and verify payment responsibility, as defined in the Health Plan Service Agreement. Input and maintain Ambulance Utilization Reporting System (AURS). Solves problems and makes recommendations for improvements; uses specialty department software; interacts effectively with members, co-workers and clients.
Essential Functions: • Dispatch appropriate transportation, based on eligibility, current contracts and medical necessity of patient; coordinate critical care transport trips with nurse managers. • Review medical records (i.e.: Emergency Department record, chart, ambulance report, etc.) relative to patient trips. Refer appropriate cases to Outside Services Manager for denial decisions. • Notify members of management's decision to deny payment, and coordinate an appeal process for ambulance trips that are being denied. Establish and maintain a file of all cases denied for payment or that are in the review process. • Independently provide clerical and/or accounting support. • Organize and prioritize duties to meet work demands. • Create, maintain, and edit specialty databases and spreadsheets for the department. • Analyze data and information to ensure accuracy and completeness. Identify errors in data, make corrections and solve problems. • Generate custom and standard reports using Excel, Access and PowerPoint, ensuring the objective of the report is communicated clearly. • Compose short correspondence clearly and effectively. Format Word documents following standard business protocols. • Work with department specific computer systems and software (AURS). • Make recommendations for process improvements. • Other duties as assignedmpleted based on submission from Hiring Manager
Grade 05
Basic Qualifications: Experience • Minimum two (2) years of work experience Education • High School Diploma or General Education Development (GED) License, Certification, Registration • N/A.
Additional Requirements: • Strong math skills and English composition. • Ability to use networked computer (email, KP intranet, internet). • Proficient in Microsoft Office, including Excel, Word and PowerPoint. Must pass basic PC skills test. • Specialized knowledge for the department as applicable. • Ability to identify, analyze and solve problems • Ability to work accurately with a high volume of work in a fast paced setting. • Demonstrate professional conduct to include dealing courteously, tactfully, and patiently with members, physicians, coworkers, and clients. • Strong oral and written communication skills. • Ability to apply knowledge of department policies and procedures, and utilize an understanding of other departments’ functions • Must pass medical terminology test when applicable • Must be willing to work in a Labor/Management Partnership environment.
Skills Testing*: PC skills Test (able to pass PC skills assessment) and Medical Terminology
*If it is determined that you need to complete testing to qualify for this position, you will receive an email inviting you to take the assessment(s) listed above. Passing test scores remain on file for one year. This position supports Kaiser Permanente's code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.
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