Kaiser Permanente
Admitting Representative - On Call
Kaiser Permanente, San Rafael, California, United States, 94911
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, processing advance directives, obtaining patient/agent signatures, initiating valuables collection and distribution, preparing documents for elective, direct and/or emergency admissions, revenue collection in all settings, and data retrieval. They ensure confidential treatment of all communications, initiate and maintain patient room assignments and status until discharge, and act as a primary informational resource for internal and external customers. The role requires independent decision‑making and a deep understanding of the financial and medical implications of admission decisions.
Essential Responsibilities
Revenue Collection
Instruct patient about 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 and refer to Financial Counselors for further action.
Obtain verification and necessary pending authorizations from non‑KP insurers (including Medicare, Medi‑Cal and COB) when the Financial Counselor is not available; complete documentation in the Member Integrated Tracking System (MITS) or appropriate KP tracking system.
When the Financial Counselor is available, discuss the need to obtain authorizations from non‑KP insurers.
Promote patient satisfaction and retention through the successful facilitation of the revenue collection process.
Calculate member liability based on benefit plan (e.g., DHMO, HDHP, Medicare D, OOP Max, etc.) and collect appropriate cost‑share payments for services rendered in all settings.
Notify patient and, when possible, collect financial liability for elective procedures.
Document all interactions.
Contact all discharged patients to attempt collection of financial liability and document interactions.
Research payment records of all non‑paying patients with liabilities, utilizing system records, and report findings to Manager/Supervisor/Designee.
Analyze revenue data to determine obstacles in cost‑share collections and report daily/weekly to Manager/Supervisor/Designee.
Collect all information necessary to bill second‑party payers (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 patient’s wrist on the side of the body opposite the intended procedure or injury per local policy.
Understand and abide by HIPAA regulations and Kaiser Permanente Corporate Compliance; provide up‑to‑date information concerning admission and hospital practices and resolve or refer patient concerns as they arise.
Facilitate the timely admission of patients throughout the hospital by coordinating patient information with physicians, ER, clinic departments, house nursing supervisor, patient care unit staff and outside care coordinators per local policy.
Receive admission requests; facilitate appropriate bed assignments and communicate information to staff.
Document and Record Management
Maintain accurate record of cost‑share status of all patients with liabilities, using the revenue tracking system 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, 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 policy.
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 professionally, courteously and positively, promoting excellent customer relations when providing information or directions to physicians, staff and public.
Maintain high standards of excellence and assist Kaiser Permanente in fulfilling its mission by providing high‑quality health care services.
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 need.
Perform other related duties as required.
Experience Minimum six (6) months work experience required. Current KP Coalition employees have this requirement waived as per the National Agreement.
Education High school diploma or equivalent.
License, Certification, Registration N/A
Additional Requirements
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).
Preferred Qualifications
Hospital/clerical setting or medical office preferred.
Revenue collection experience preferred.
Grade 05
Seniority level Entry level
Employment type Full‑time
Job function Other
Industries Hospitals and Health Care
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Essential Responsibilities
Revenue Collection
Instruct patient about 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 and refer to Financial Counselors for further action.
Obtain verification and necessary pending authorizations from non‑KP insurers (including Medicare, Medi‑Cal and COB) when the Financial Counselor is not available; complete documentation in the Member Integrated Tracking System (MITS) or appropriate KP tracking system.
When the Financial Counselor is available, discuss the need to obtain authorizations from non‑KP insurers.
Promote patient satisfaction and retention through the successful facilitation of the revenue collection process.
Calculate member liability based on benefit plan (e.g., DHMO, HDHP, Medicare D, OOP Max, etc.) and collect appropriate cost‑share payments for services rendered in all settings.
Notify patient and, when possible, collect financial liability for elective procedures.
Document all interactions.
Contact all discharged patients to attempt collection of financial liability and document interactions.
Research payment records of all non‑paying patients with liabilities, utilizing system records, and report findings to Manager/Supervisor/Designee.
Analyze revenue data to determine obstacles in cost‑share collections and report daily/weekly to Manager/Supervisor/Designee.
Collect all information necessary to bill second‑party payers (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 patient’s wrist on the side of the body opposite the intended procedure or injury per local policy.
Understand and abide by HIPAA regulations and Kaiser Permanente Corporate Compliance; provide up‑to‑date information concerning admission and hospital practices and resolve or refer patient concerns as they arise.
Facilitate the timely admission of patients throughout the hospital by coordinating patient information with physicians, ER, clinic departments, house nursing supervisor, patient care unit staff and outside care coordinators per local policy.
Receive admission requests; facilitate appropriate bed assignments and communicate information to staff.
Document and Record Management
Maintain accurate record of cost‑share status of all patients with liabilities, using the revenue tracking system 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, 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 policy.
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 professionally, courteously and positively, promoting excellent customer relations when providing information or directions to physicians, staff and public.
Maintain high standards of excellence and assist Kaiser Permanente in fulfilling its mission by providing high‑quality health care services.
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 need.
Perform other related duties as required.
Experience Minimum six (6) months work experience required. Current KP Coalition employees have this requirement waived as per the National Agreement.
Education High school diploma or equivalent.
License, Certification, Registration N/A
Additional Requirements
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).
Preferred Qualifications
Hospital/clerical setting or medical office preferred.
Revenue collection experience preferred.
Grade 05
Seniority level Entry level
Employment type Full‑time
Job function Other
Industries Hospitals and Health Care
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