Under the direct supervision of the department Supervisor, this position is responsible for using computerized internal system applications to post payments, process, and review adjustments from insurance carriers. Within departmental guidelines, reviews explanations of benefits, compares payments with charge information, prepares and processes adjustments based on review of EO - Bs for non-standard Fee Schedule and for non-payment or underpayments. Maintains reporting of trends for billing erro... more details
Description:
Job Summary:
Under the direct supervision of the department Supervisor, this position is responsible for using computerized internal system applications to post payments, process, and review adjustments from insurance carriers. Within departmental guidelines, reviews explanations of benefits, compares payments with charge information, prepares and processes adjustments based on review of EOBs for non-standard Fee Schedule and for non-payment or underpayments. Maintains reporting of trends for billing errors, down-coding and other carrier specific practices.
Essential Responsibilities:
Interacts daily with various departments, vendors and payers to determine appropriate disposition of payments received.
Reconciles and posts payments to accounts receivable systems.
Processes adjustments on a line item basis.
Researches and determine the appropriate application of undistributed payments.
Processes dishonored check activity.
Transfers liability of balances.
Reviews EOBs for non-standard Fee Schedule reductions and for non-payment or under payment trends based upon carrier practices that may affect reimbursement.
Maintains EOB files as needed.
Processes assigned KP HealthConnect work queues.
Provides customer service liaison between payers, vendors and Kaiser.
Performs other related duties as assigned including but not limited to special projects.
Note: Internal PFS candidates may have job advancement opportunities via the PFS Career Ladder, and should consult with their supervisor and/or manager.
Pay Grade 18
Basic Qualifications:
Experience
Basic Qualification:
Minimum 2 years bookkeeping, accounts receivable, Collector, Biller or Patient Billing Resolution experience or any combination of the above, with both years in a healthcare environment within the last four years.
The Basic Computer Literacy Assessment score must be current within one (1) year (contact Local HR Office for testing). Must obtain passing score on the Basic Computer Literacy Assessment (passing score set at 75).
Education
High School Diploma or GED.
Basic minimum required quals OR successful completion of the PFS Career Ladder curriculum that is mapped to that position.
License, Certification, Registration
N/A
Additional Requirements:
Proficient in Excel, Word and Windows.
Strong interpersonal, and verbal and written communication skills.
Ability to read, write and perform basic mathematical computations at a high school level.
Ability to work well in a team environment and within the Labor
Management Partnership guidelines and effectively participate in Unit Based Teams. Ability to sit for long periods of time.
Ability to use general office equipment including telephones, fax, copier, etc.
Ability to lift a minimum of 20 pounds.
Preferred Qualifications:
Ability to demonstrate knowledge of federal Workers Compensation Regulations, Relative Value Studies (RVS), Fee Schedule Allowance and reduction and medical terminology and/or Billing.
Working knowledge of ACCESS.
Working knowledge of Generally Accepted Accounting Principles (GAAP).
Demonstrates knowledge of the SCAL and NCAL Uniform Chart of Accounts, all systems - North and South, such as ARBIS, ARRS, Foundations, KPTPX, SAR (NCAL and SCAL), CUBS, OPAS, CIPS.
Uses all NCAL and SCAL systems to determine correct account for payment processing.
AA Degree in Business or certification in insurance billing issued by an accredited institution.
Job Abstracts is an independent Job Search Engine. Job Abstracts is not an agent or representative and is not endorsed, sponsored or affiliated with any employer. Job Abstracts uses proprietary technology to keep the availability and accuracy of its job listings and their details. All trademarks, service marks, logos, domain names, and job descriptions are the property of their respective holder. Job Abstracts does not have its members apply for a job on the jobabstracts.com website. Additionally, Job Abstracts may provide a list of third-party job listings that may not be affiliated with any employer. Please make sure you understand and agree to the website's Terms & Conditions and Privacy Policies you are applying on as they may differ from ours and are not in our control.
Welcome to Job Abstracts
We would like to take a second to Welcome You to Job Abstracts, the nation’s largest Pure Job Board. With over 3.1 million job listings from 15,000+ Companies & Organizations, we help job searchers find careers that match their interests. As an anonymous user, you have probably discovered how easy our system is to use. However, you have just scratched the surface of what we can offer.
We encourage you to Register so you can use our most powerful features: searching with multiple terms, setting up multiple locations, establishing favorite companies, and accessing your search history. If you find a job you like, you can apply directly for it, and then, keep notes on it. We will also keep a lookout for jobs that match your search terms and email you when we find something you may like.
You can register for free and the system is free to use. If you like our system so far, click on Register and unlock the power required by serious job searchers.
Any time you conduct a search, the system shows you job matches, ranked by their Relevance Score (RS).
The score is calculated by a proprietary algorithm that uses Intelligent Machine Learning.
The Relevance Score tells you how well the job opportunity matches your search term or terms.
When not logged in, the system is limited to one search term. Scores for single term matches are usually lower.
When you register, log in, and set up multiple terms prioritized by importance, the jobs found for you will receive a much higher Relevance Score.