Kaiser Permanente Northwest
Patient Access Representative
Kaiser Permanente Northwest, Hillsboro, Oregon, United States, 97104
Job Title:
Patient Access Representative I
Employer:
Kaiser Permanente Northwest
Summary
The Patient Access Representative I is a role within the Kaiser Permanente Health System environment. The Patient Access Representative I welcomes patients into the care delivery setting and initiates administrative systems that lay the groundwork for clinical care and financial documentation. Responsibilities include ensuring a complete and accurate patient admission/registration, collecting registration data, performing limited insurance eligibility and benefits verification, point-of-service cash collection, and completing documentation necessary for expedient registration/admission according to organizational policy, procedures, and federal/state/regulatory requirements. The role may involve obtaining inpatient bed assignments and processing inpatient admissions (including direct admit) following patient identification protocols and completing necessary documentation. The position may refer patients to Financial Counselors for Medical Financial Assistance and answers or refers questions from patients, visitors, or staff as appropriate. It involves cash handling procedures per SOX controls, and acts as an ambassador to ensure a patient-friendly experience. The incumbent has knowledge of state and federal regulations governing patient encounters and ensures compliance. It supports the patient and family care experience and helps them understand Kaiser Permanente facilities and routines. It works with both the financial team (Patient Business Services and payors) and the clinical team (nursing, physicians, hospital supervisors, etc.) to ensure an optimal patient experience, accurate registration, cash flow, and reimbursements. This is an intermediate level role requiring a professional, service-oriented individual with strong organization skills working under limited supervision. The work environment may be stressful or high-volume, including front-line registration and the Emergency Department, and requires compassion, respect, and understanding in interactions with patients and families. The role requires strong organization, prioritization, good judgment, diplomacy, and independent thinking. Internal contacts include physicians, staff and management across the organization (e.g., Patient Business Services, Patient Access Representative II and III, Utilization Management, Patient Flow Coordinators/HAS, Health Information Management). External contacts include patients, families, community physicians, and external organizations such as government agency representatives. Independent decision-making is required in daily routine functions, with major decisions subject to review and approval. Staff may perform all or a combination of duties depending on assigned area and department needs.
Essential Responsibilities
Registration:
Greets and registers patients for various medical services in hospital settings, potentially 24/7 and in fast-paced environments such as the Emergency Department. Pre-registers patients where applicable. Conducts interviews to obtain demographic information, insurance data, and third-party liability information. Performs minimal eligibility verification, identifies needs for financial assistance and refers to the Financial Counselor as necessary. Verifies demographics and insurance information per CMS regulations, National Registration Standards, and regional policies. Verifies member eligibility and benefits using available verification programs. Verifies patient identity to minimize duplicate records. Documents insurance information (primary, secondary, tertiary) and performs registration for all patient classes and services.
Revenue Collection:
Determines and collects cost-shares and partial payments. Processes payments, closes cash drawers, and prepares deposits per cash-handling policies. Communicates patient liability policies for payment of services or prepayment when significant liabilities exist. Refers to financial counselors as appropriate. Coordinates with Patient Business Services/Membership Services on account status and documents all activity in the system.
Appointing:
May schedule or cancel appointments as needed and return appointments when applicable.
Regulatory/Organizational Compliance:
Completes required forms for payors (Medicare, LM/LI, etc.), obtains signatures, and scans/captures documents. Ensures compliance with Medicare, Medicaid, Managed Care, and Commercial payors regarding referrals, preauthorization, and pre-certification. Maintains accuracy of Medicare Secondary Payer screening. Receives physician orders and, if applicable, performs medical necessity checks. Understands HIPAA privacy and security regulations and EMTALA relevance to registration and liability.
General Services:
Stocks forms and supplies, assists patients with directions and department navigation, escorts patients to service areas, and handles safeguarding of valuables per policy. Provides information to patients, visitors, and the public about hospital policies and procedures. Maintains records during downtime and contributes to data gathering as needed.
Experience
Minimum one (1) year of healthcare financial experience and one (1) year in an office environment with customer service, or Minimum two (2) years of post-high school related education or a combination of education and experience.
Per the National Agreement, current KP Coalition employees have this experience requirement waived.
Education
High School Diploma or GED required.
License, Certification, Registration
Basic Life Support
Medical Terminology Certification
Additional Requirements
Must obtain Medical Terminology certification within 180 days if currently a Patient Access employee, or have proof of completion if external hire.
Must obtain CPR certification within 30 days if currently a Patient Access employee, or have proof of current CPR certification if external hire.
Excellent communication, organizational and written skills; ability to switch tasks frequently.
Ability to type at least 35 wpm with high accuracy.
Previous cash handling experience.
Proficiency with CRT, Windows-based systems (MS Word/Excel), copier, fax, phone, and headset.
Ability to read continuously and handle a high volume of work.
Knowledge of Medicaid, Medicare, and other government and payer requirements.
Knowledge of basic state and federal healthcare regulations (HIPAA, EMTALA, etc.).
Experience with automated patient care systems for admissions, registration, and medical records functions.
Familiarity with funding resources and billing systems; ability to maintain confidentiality per policies.
Preferred Qualifications
Training to become a Certified Healthcare Access Associate by NAHAM within 180 days of employment (preferred).
Experience with EPIC applications (preferred).
Hospital or ambulatory clinic registration experience (preferred).
HFMA or NAHAM certification preferred.
One year of higher education preferred.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at Kaiser Permanente Northwest.
Beaverton, OR
#J-18808-Ljbffr
Patient Access Representative I
Employer:
Kaiser Permanente Northwest
Summary
The Patient Access Representative I is a role within the Kaiser Permanente Health System environment. The Patient Access Representative I welcomes patients into the care delivery setting and initiates administrative systems that lay the groundwork for clinical care and financial documentation. Responsibilities include ensuring a complete and accurate patient admission/registration, collecting registration data, performing limited insurance eligibility and benefits verification, point-of-service cash collection, and completing documentation necessary for expedient registration/admission according to organizational policy, procedures, and federal/state/regulatory requirements. The role may involve obtaining inpatient bed assignments and processing inpatient admissions (including direct admit) following patient identification protocols and completing necessary documentation. The position may refer patients to Financial Counselors for Medical Financial Assistance and answers or refers questions from patients, visitors, or staff as appropriate. It involves cash handling procedures per SOX controls, and acts as an ambassador to ensure a patient-friendly experience. The incumbent has knowledge of state and federal regulations governing patient encounters and ensures compliance. It supports the patient and family care experience and helps them understand Kaiser Permanente facilities and routines. It works with both the financial team (Patient Business Services and payors) and the clinical team (nursing, physicians, hospital supervisors, etc.) to ensure an optimal patient experience, accurate registration, cash flow, and reimbursements. This is an intermediate level role requiring a professional, service-oriented individual with strong organization skills working under limited supervision. The work environment may be stressful or high-volume, including front-line registration and the Emergency Department, and requires compassion, respect, and understanding in interactions with patients and families. The role requires strong organization, prioritization, good judgment, diplomacy, and independent thinking. Internal contacts include physicians, staff and management across the organization (e.g., Patient Business Services, Patient Access Representative II and III, Utilization Management, Patient Flow Coordinators/HAS, Health Information Management). External contacts include patients, families, community physicians, and external organizations such as government agency representatives. Independent decision-making is required in daily routine functions, with major decisions subject to review and approval. Staff may perform all or a combination of duties depending on assigned area and department needs.
Essential Responsibilities
Registration:
Greets and registers patients for various medical services in hospital settings, potentially 24/7 and in fast-paced environments such as the Emergency Department. Pre-registers patients where applicable. Conducts interviews to obtain demographic information, insurance data, and third-party liability information. Performs minimal eligibility verification, identifies needs for financial assistance and refers to the Financial Counselor as necessary. Verifies demographics and insurance information per CMS regulations, National Registration Standards, and regional policies. Verifies member eligibility and benefits using available verification programs. Verifies patient identity to minimize duplicate records. Documents insurance information (primary, secondary, tertiary) and performs registration for all patient classes and services.
Revenue Collection:
Determines and collects cost-shares and partial payments. Processes payments, closes cash drawers, and prepares deposits per cash-handling policies. Communicates patient liability policies for payment of services or prepayment when significant liabilities exist. Refers to financial counselors as appropriate. Coordinates with Patient Business Services/Membership Services on account status and documents all activity in the system.
Appointing:
May schedule or cancel appointments as needed and return appointments when applicable.
Regulatory/Organizational Compliance:
Completes required forms for payors (Medicare, LM/LI, etc.), obtains signatures, and scans/captures documents. Ensures compliance with Medicare, Medicaid, Managed Care, and Commercial payors regarding referrals, preauthorization, and pre-certification. Maintains accuracy of Medicare Secondary Payer screening. Receives physician orders and, if applicable, performs medical necessity checks. Understands HIPAA privacy and security regulations and EMTALA relevance to registration and liability.
General Services:
Stocks forms and supplies, assists patients with directions and department navigation, escorts patients to service areas, and handles safeguarding of valuables per policy. Provides information to patients, visitors, and the public about hospital policies and procedures. Maintains records during downtime and contributes to data gathering as needed.
Experience
Minimum one (1) year of healthcare financial experience and one (1) year in an office environment with customer service, or Minimum two (2) years of post-high school related education or a combination of education and experience.
Per the National Agreement, current KP Coalition employees have this experience requirement waived.
Education
High School Diploma or GED required.
License, Certification, Registration
Basic Life Support
Medical Terminology Certification
Additional Requirements
Must obtain Medical Terminology certification within 180 days if currently a Patient Access employee, or have proof of completion if external hire.
Must obtain CPR certification within 30 days if currently a Patient Access employee, or have proof of current CPR certification if external hire.
Excellent communication, organizational and written skills; ability to switch tasks frequently.
Ability to type at least 35 wpm with high accuracy.
Previous cash handling experience.
Proficiency with CRT, Windows-based systems (MS Word/Excel), copier, fax, phone, and headset.
Ability to read continuously and handle a high volume of work.
Knowledge of Medicaid, Medicare, and other government and payer requirements.
Knowledge of basic state and federal healthcare regulations (HIPAA, EMTALA, etc.).
Experience with automated patient care systems for admissions, registration, and medical records functions.
Familiarity with funding resources and billing systems; ability to maintain confidentiality per policies.
Preferred Qualifications
Training to become a Certified Healthcare Access Associate by NAHAM within 180 days of employment (preferred).
Experience with EPIC applications (preferred).
Hospital or ambulatory clinic registration experience (preferred).
HFMA or NAHAM certification preferred.
One year of higher education preferred.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at Kaiser Permanente Northwest.
Beaverton, OR
#J-18808-Ljbffr