OHS Claims Processor I (Bilingual)
Company: Kaiser Permanente
Posted on: May 12, 2022
Under direct supervision, Provides patient/visitor reception;
check in and out; cash handling appointment scheduling and other
Occupational Health Service's duties clerical duties as directed.
Obtains employer/carrier information for billing/reporting
purposes; contact employers/carriers to obtain authorization for
treatment or report status of claims. Review of records to identify
potential billing opportunities and transfer charges to appropriate
account, if applicable. Enter pertinent claim information into KP
internal computer systems. Ordering and photocopying medical
records; temporarily cover other desk/functions due to vacation and
workload fluctuations; clears designated Health Connect work queues
daily, creates patient accounts to register patients and fills in
the required KP computerized systems, provides personalized and
professional patient/employer/carrier services. Individual must be
customer service oriented. Extensive contact with members,
non-members, physicians, third party administrators/carriers and
employers/clients. Must be able to provide status of claim; create
patient accounts and files; Input and maintain information on all
appropriate systems as utilized by Kaiser Permanente. Requires
excellent interpersonal skills and the ability to multitask in a
Answer and screen incoming phone calls for the department.
Receives and filters messages to providers/clinicians/case
managers/case coordinators through the Health Connect system and
reply as appropriate.
Greet patients/visitors and determine nature of visit.
Handles customer inquires.
Assists patients in completing required forms.
Request for internal /external records.
Creates accounts in the KP internal systems.
Transfer charges to the appropriate KP Health Connect patient
Schedule appointments for workers' compensation patients.
Interact with internal/external customers to schedule appointments
or obtain information.
Make rounds to certain internal departments to retrieve paperwork,
Consolidate or corrects duplicate accounts by using appropriate
Enters account notes on patient cases.
Reviews subpoena requests.
Review KP internal systems to ensure that duplicate visits are not
Complete transfer of care forms.
Clear designated Health Connect work queues daily.
Open and distribute mail to proper areas; match bills to reports
and mail to carrier along with any other documentation as
Type various documentation as required in our current KP systems.
Prepare office supply orders.
Payment and collection for OHSS services, as required.
Performs other related duties as required to maintain efficient
Promotes, ensures and improves customer service to
internal/external customers by demonstrating skills which are
consistent with the organization's philosophy of providing
extraordinary customer relations and quality service as well as all
other Kaiser Permanente Policy Procedures.
Pay Grade 13
Minimum of one (1) year relevant clerical and customer service
experience in Workers' Compensation.
Cash handling experience.
High school diploma/GED.
Typing 35 wpm required.
All testing must be completed by the end of posting period.
Successfully passed a medical terminology test.
Knowledge of Workers' Compensation claims Processing.
Ability to research, summarize and communicate clearly to the
public, both verbally and in writing.
Ability to use computer to perform assigned duties.
Equipment Utilized: Computer, Adding Machine, Fax Machine,
Photocopier, Telephone and Typewriter.
- Bilingual (English/Spanish) Level I
- Speak Spanish.
- Must have excellent customer service skills and Workers'
Compensation or any insurance background is a plus
- Must successfully pass or have passed the bilingual test
(within the last 12 months), or be active in the QBS program.
PrimaryLocation : California,Oxnard,Oxnard 2200 E. Gonzales Rd.
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:30 AM
WorkingHoursEnd : 05:00 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : B01-SEIU-Local 399
Job Level : Individual Contributor
Job Category : Insurance & Claims
Department : Woodland Hills MOB - Occupational Health-Reg Clin -
Travel : Yes, 25 % of the Time
Kaiser Permanente is an equal opportunity employer committed to a
diverse and inclusive workforce. Applicants will receive
consideration for employment without regard to race, color,
religion, sex (including pregnancy), age, sexual orientation,
national origin, marital status, parental status, ancestry,
disability, gender identity, veteran status, genetic information,
other distinguishing characteristics of diversity and inclusion, or
any other protected status.
Keywords: Kaiser Permanente, Oxnard , OHS Claims Processor I (Bilingual), Other , Oxnard, California
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