Business Rep
Business Rep - Grade 6
Under direct supervision, the Business Representative is a professional responsible for identification of non-automated prospective and retrospective billable services and resolution of billing inquiries. Essential Functions: Includes but is not limited to: - Responsible for researching and resolving Guarantor and Patient Account edits. - Identify and capture non-automated charges. - Research and resolve all inquiries and billing requests (via telephone, correspondence or workqueue). - Research and resolve refund requests. - Research and resolve Request for Information Tracking System (RITS) requests. - Validate co-payment discrepancies between patient and KP systems. - Produce co-payment history reports upon request. - Create bills for Pro Fee services provided at non-KP facilities. - Noting all activities in the Kaiser Permanente system of record (KP HealthConnect). - Other duties as assigned by supervisor. The Business Representative works collaboratively with Hospital, Clinic, Emergency Department and Member Services personnel. The Business Representative must be capable of making decisions and working independently to accomplish all responsibilities, as well as maintain an in-depth understanding of job duties and operational changes where decisions have significant financial implications. This position has no supervisory responsibilities. Qualifications: Basic Qualifications: - Twenty-four (24) months of work experience, including twelve (12) months of hospital, medical office or insurance company required. - High school diploma or equivalent. - Basic knowledge and use of computer and computer keyboard (able to pass PC skills assessment and keyboarding test a rate of 6,000 keystrokes/hour is required to pass ). - Proficient in medical terminology (able to pass KP standardized test). - Ability to identify billable facility and professional fees from medical records and computer systems for designated services not addressed through automation; knowledge of charge capture rules (able to pass charge capture test). - Ability to multitask, organize and prioritize and work independently with minimal supervision. - Must be willing to work in a Labor Management Partnership environment. Skills Testing: PC Skills, Keyboarding Test (a rate of 6,000 keystrokes/hour ), Medical Terminology, Charge Capture Test