Admitting Representative
Kaiser Permanente
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 Responsibilities:
- 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 Manager/Supervisor/Designee.-- Analyze revenue data to determine obstacles in cost
share collections. Report daily/weekly to Manager/Supervisor/Designee.-- Collect all information necessary to bill secondparty 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 compliance.
-
- Affix identification bracelet to the patients wrist on the side of the body opposite the intended procedure or injury per local
policy.
-
- 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 policy.
-
- 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 by management.
-
- 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.
COMPANY: KAISER
TITLE: Admitting Representative
LOCATION: Richmond, California
REQNUMBER: 1362085
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Por favor confirme su dirección de correo electrónico: Send Email