Company: Kaiser Permanente Zion Medical Center
Location: Walnut Creek
Posted on: September 23, 2022
Job Summary:Under the direct supervision of the Admitting
Manager/Supervisor/Designee, the Admitting Representative is a
patient service professional responsible for coordinating and
completing every phase of the admission function including
admissions, pre-admissions, interviews for financial and
demographic information, obtains and processes advance directives,
obtains patient/agent signatures, may initiate valuables collection
and distribution, document preparation for all elective, direct
and/or emergency admissions, revenue collection in all settings,
and data retrieval. Assures confidential treatment of all
communications written and verbal. Will initiate and maintain
patient room assignments and status until discharge. Acts as a
primary informational resource and provides assistance to both
internal and external customers. The Admitting Representative must
be capable of making decisions and working independently to achieve
all departmental functions, as well as maintain an in-depth
understanding of job duties and changes as admitting decisions have
significant financial and medical implications.Essential
- REVENUE COLLECTION
- Instruct and review with patient, information concerning
hospitalization. Ascertain health plan status, research eligibility
and collect and copy non-KP insurance information.
- Identify all uninsured or under-insured patients admitted to
facility; refer to Financial Counselors for further action.
- Obtain verification and necessary pending authorizations from
non-KP insurers (including Medicare, Medi-Cal and COB) on members
and non-members when Financial Counselor is not available. All
documentation is completed in the Member Integrated Tracking System
(MITS) or the appropriate KP tracking system.
- When Financial Counselor is available, discuss the need to
obtain authorizations from non-KP insurers (including Medicare,
Medi-Cal and COB).
- Promote patient satisfaction and retention through the
successful facilitation of the revenue collection process.
- Calculate member liability based on benefit plan (e.g.
Deductible Health Maintenance Organization (DHMO), High Deductible
Health Plan (HDHP), Medicare D, Out of Pocket Maximum (OOP Max),
etc.); inform patient/agent and collect appropriate cost share
payments for services rendered in all settings (e.g. bedside,
follow up phone calls to patients home, etc.)
- Notify patient and when possible, collect financial liability
for elective procedures.
- Document all interactions.
- Contact all discharged patients to attempt collection of
financial liability. Document all interactions.
- Research payment records of all non-paying patients with
liabilities, utilizing system records. Report findings to
- Analyze revenue data to determine obstacles in cost share
collections. Report daily/weekly to Manager/Supervisor/Designee.
- Collect all information necessary to bill second-party payers,
e.g. COB, Medicare, Medi-Cal, third-party payers, Workers
Compensation, Commercial and Non-KP HMO.
- PATIENT INTERVIEW/PREADMISSION AND ADMISSION
- Interview patients for pre-admission or admission to the
hospital, collecting personal, demographic, financial and medical
information in person or by phone per KP policies.
- Enter complete data into the KP information systems and review
for accuracy per department, local, regional and regulatory
- Affix identification bracelet to the patients wrist on the side
of the body opposite the intended procedure or injury per local
- Understand and abide by the HIPAA regulations and Kaiser
Permanente Corporate Compliance. Provide up-to-date information
concerning admission and hospital practices and administrative
procedures per HIPAA guidelines. Evaluate and attempt to
resolve/refer public and patient concerns as they arise.
- Facilitate the timely admission of patients throughout the
hospital by coordinating patient information with the physicians,
Emergency Room, Clinic Departments, House Nursing Supervisor,
Patient Care Unit Staff and Outside Care Coordinators per local
- Receives admission requests; facilitates appropriate bed
assignments and communicates information to staff.
- DOCUMENT AND RECORD MANAGEMENT
- Maintain accurate record of cost share status of all patients
with liabilities, utilizing revenue tracking system as determined
- Obtain appropriate signatures on permits and consents per
California Hospital Association (CHA) consent guidelines.
- Prepare related admission paperwork in advance to facilitate a
timely admission process.
- Assemble and coordinate admission materials to create a
comprehensive admission package.
- Distribute relevant brochures/letters to patient/agent (e.g.
Medicare letter, Coordination of Benefits (COB) brochure, advance
directive brochure, cost share letter, etc.)
- Receive, document, secure and release patient valuables
according to Standard Procedure 18A as appropriate.
- Initiate membership records on all newborns per local
- Distribute admission materials to proper locations.
- CUSTOMER SERVICE
- Participate in problem-solving as needed to assure
organizational revenue targets and customer satisfaction.
- Escort or arrange for patient escort to assigned room or area
per local policy.
- Answer phones in a professional, courteous and positive manner
promoting excellent customer relations when providing
information/directions to physicians, staff and public.
- Maintain high standards of excellence and assist Kaiser
Permanente fulfill its mission by providing high-quality health
- OTHER DUTIES
- Work in a team environment continually enhancing required
skills through scheduled training sessions or individually; attend
required meetings, workshops and in-services.
- Provide support in conducting audits depending upon supervisory
- Perform other related duties as required. Grade 5Basic
- Six months work experience required. Basic knowledge and use of
computer and computer keyboard (able to pass PC skills assessment)
Professional customer service skills Ability to read, write,
understand and follow oral and written instructions Ability to
effectively present information in one-on-one and small group
situations to customers and other personnel within the organization
Ability to use basic math Ability to work rapidly and accurately
with phone, personnel and patient interruptions Ability to
multitask, organize and prioritize and work independently with
minimal supervision Proficient in admitting medical terminology
(able to pass standardized test) Must be willing to work in a Labor
Management Partnership environment. 35 wpm typing or 6000 data
entry keystrokes (able to pass either test). Education
- High school diploma or equivalent. License, Certification,
- N/A Additional Requirements: Preferred Qualifications:
- Hospital/clerical setting or medical office preferred Revenue
collection experience preferred Proficient in word-processing,
spreadsheet programs, etc. preferred.
Keywords: Kaiser Permanente Zion Medical Center, Walnut Creek , Admitting Representative, Other , Walnut Creek, California
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