Under the direct supervision of the Admitting Manager/Supervisor/Designee, the Admitting Representative is a patient service professional responsible for coordinating & completing every phase of the admission function including: admissions, pre-admissions, interviews for financial & demographic information, obtains & processes advance directives, obtains patient/agent signatures, may initiate valuables collection & distribution, document preparation for all elective, direct and/or emergency admissions, revenue collection in all settings, & data retrieval.
Essential Functions:
- Instructs & reviews with patient, information concerning hospitalization
- Identifies all uninsured or under-insured patients admitted to facility; refer to Financial Counselors for further action
- Obtains verification & necessary pending authorizations from non-KP insurers (including Medicare, Medi-Cal and COB) on members & 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, discusses the need to obtain authorizations from non-KP insurers
- Promotes patient satisfaction & retention through the successful facilitation of the revenue collection process
- Calculates member liability based on benefit plan
- Collects financial liability for elective procedures & discharged patients
- Researches payment records of all non-paying patients with liabilities, utilizing system records
- Reports findings to Manager/Supervisor/Designee
- Analyzes revenue data to determine obstacles in cost share collections
- Collects all information necessary to bill second-party payers
- Interviews patients for pre-admission or admission to the hospital, collecting personal, demographic, financial, & medical information in person or by phone per KP policies
- Enters complete data into the KP information systems & review for accuracy per department, local, regional, & regulatory compliance
- Affixes identification bracelet to the patient's wrist on the side of the body opposite the intended procedure or injury per local policy
- Provides up-to-date information concerning admission & hospital practices & administrative procedures per HIPAA guidelines & Kaiser Permanente Corporate Compliance
- Facilitates the timely admission of patients throughout the hospital by coordinating patient information w/the physicians, Emergency Room, Clinic Departments, House Nursing Supervisor, Patient Care Unit Staff, & outside Care Coordinators per local policy
- Receives admission requests; facilitates appropriate bed assignments & communicates information to staff
- Obtains appropriate signatures on permits & consents per California Hospital Association (CHA) consent guidelines
- Prepares related admission paperwork in advance to facilitate a timely admission process.
- Distributes relevant brochures/letters to patient/agent (e.g. Medicare letter, Coordination of Benefits (COB) Brochure, advance directive brochure, cost share letter, etc.)
- Receives, documents, secures & releases patient valuables according to Standard Procedure 18A as appropriate
- Initiates membership records on all newborns per local policy
- Distributes admission materials to proper locations
- Escorts or arranges for patient escort to assigned room or area per local policy
- This job has no supervisory responsibilities
- Performs other related duties as required
Qualifications:
Basic Qualifications:
- Six (6) months of work experience within the last twelve (12) months required
- Hospital/clerical setting or medical office preferred
- Revenue collection experience preferred
- High school diploma or equivalent
- Typing speed: 35 wpm typing or 6000 data entry keystrokes (able to pass either test)
- Basic knowledge & use of computer & computer keyboard (able to pass PC skills assessment)
- Professional customer service skills
- Ability to read, write, understand & follow oral & written instructions
- Ability to effectively present information in one-on-one & small group situations to customers & other personnel within the organization
- Ability to use basic math
- Ability to work rapidly & accurately w/ phone, personnel & patient interruptions
- Ability to multitask, organize & prioritize & work independently w/ minimal supervision
- Proficient in admitting medical terminology (able to pass standardized test)
- Proficient in word-processing, spreadsheet programs, etc. preferred
- Must be willing to work in a Labor Management Partnership environment
Skills Testing: Typing (35 WPM or 6,000 KPH), PC Skills, Medical Terminology for Admitting Rep
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.