COLLECTOR II - (HEALTHCARE SELF-PAY) PFS (BILINGUAL)

Description : Job Summary : Within Regional and Departmental Policies & Procedures and under direct supervision, this position is responsible for the collection of delinquent billed accounts and resolving outstanding receivables by performing collection and claim status follow-up activities, settlement negotiations, processing appeals, identifying and processing adjustments and other write-offs, and agency assignments for qualified accounts by processing and notating accounts in the host system.

Essential Responsibilities : Determine appropriate collection action by processing accounts in assigned work queues (e.g.

KPHC Work Queues, collector assignment report, aging reports, etc.).Responsible for follow-up and collection of accounts, including, but not limited to : inpatient, outpatient, emergency room, and pharmacy charges for all in- and out-of-network services, etc.

by various means (systems, reports, etc.).Make recommendations as well as make decisions to refer accounts to appropriate line of business for billing / rebilling and / or outside collection agencies at any stage of the internal collection process.

Review accounts to ensure compliance with applicable local, state, and / or federal law and regulations, including organization policies and procedures.

Correspond with interested parties to resolve receivables via in-coming and out-going telephone, fax, mail, e-mail, telegram, and / or legal correspondence for accounts.

Update accounts receivable systems and department databases that maintain detailed insurance and claim information for collection of accounts with appropriate account notes regarding follow-up activities and any appropriate account revisions.

Effectively collect balances due with any applicable penalties and interest on assigned accounts.Responsible for gathering information, making recommendations related to adjustments of uncollectible balances and completing accounts appropriately.

Identify accounts which require refunds, calculate refund amounts, and refer accounts to appropriate support staff.Respond to in-coming correspondence and telephone inquiries from patients, guarantors, third parties, attorneys, and other KP facilities or departments, etc.

regarding accounts.Make referrals to appropriate departments to resolve any initial and supplemental billing issues.When necessary, work with staff of various business offices, insurance carriers, Corona Call Center, member service departments, provider areas and California Service Center (CSC) to facilitate corrections or other required revisions necessary to collect assigned accounts.

Responsible for initiating out-bound collection calls and handling in-bound call volumes within the standard(s) established by the department.

Achieve individual production and quality assurance performance within established expectations and ply with legal and ethical requirements to protect patient, employee, and KFHP confidentiality.

Identify and communicate ways of improving department processes, procedures and customer relations by participating in Unit Based Teams and other Labor Management Partnership terpret benefits, exclusions and accurate reimbursement levels of primary and secondary insurance coverage.

Review and interpret Explanation of Benefits (EOB) to ensure all revenue-generating possibilities have been exhausted and take appropriate action, including but not limited to : posting adjustments, posting denials, processing appeals, changing financial classes, processing adjustments and write-offs, rebilling / secondary billing, etc.

Responsible for electronic billing / paper billing and interface between KP billing facilities and external entities.Utilize documentation (e.

g., settlement draft, settlement release, awards issued by the court) to ensure maximum case settlement and take appropriate action for the following : posting adjustments, posting denials, processing appeals, changing financial classes, processing revenue reversals, write-off, rebilling / secondary billing, etc.

Assist with preparation of cases for litigation by collecting supporting documentation.Verification of pertinent account data (i.

e., coverage, benefits, eligibility, authorization, etc.)that is required to facilitate collection activities and / or write-off recommendations.

Perform other 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 18Basic Qualifications : ExperienceMinimum two (2) years experience as collector, biller, or customer service representative in related health care patient accounting field within the last four (4) years;

OR combination of all three above; OR One (1) year of collector experience combined with a Line of Business Training Certificate for KFHP Collectors.

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).

EducationHigh school diploma or GED.Basic minimum required experience / certifications OR successful completion of the PFS Career Ladder curriculum that is mapped to that position.

• License, Certification, RegistrationN / AAdditional Requirements : Ability to demonstrate knowledge of the Fair Debt Collection Practices Act and NAIC Guidelines;
• local, state, and / or federal Commercial laws and regulations; billing requirements, to include, but not limited to : ICD-9, CPT, and DRG codes, and fee schedule allowances and reductions;

medical terminology and calculations necessary for account management.Ability to demonstrate knowledge of line of business specific billing and collection rules, regulations and other pertinent payer specific requirements.

Demonstrated ability to work with patient accounting and computerized collection systems and use Windows operating system and Microsoft Office Applications (WORD, EXCEL, etc.

Demonstrated ability to utilize and apply active listening, communication, and persuasion skills, as well as the principles and processes needed to provide customer service.

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 lift 20 pounds. Ability to sit for long periods of time.Ability to use general office equipment including telephones, fax, copier, etc.

Must be able to work in a Labor Management Partnership.Bilingual (English / Spanish) Level II required.Preferred Qualifications : AA degree in Business or certification in insurance billing or collections issued by an accredited learning institution.

Multi-lingual.Notes : Self-Pay CollectorMust successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.

Primary Location : California,Pasadena,West Annex - Parsons 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 Employee Status : Regular Employee Group / Union Affiliation : B01SEIULocal 399 Job Level : Individual Contributor Department : Parsons East Annex - Commercial Collections - 0808 Pay Range : $31.

15 - $34.28 / 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 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.

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