Salary Job Openings

Medical Insurance Data Clerk - MHS

Kaiser Permanente
Wailuku, HI Full Time
POSTED ON 3/13/2020 CLOSED ON 7/13/2020

Job Posting for Medical Insurance Data Clerk - MHS at Kaiser Permanente


Under direct supervision, researches, extracts, codes and enters patient demographics, charges and adjustments; verifies insurance benefits; performs final billing; refers claims to insurance area as necessary; researches and reconciles payments from insurance and self-pay; verifies account balances; initiates transfers if necessary.


Essential Responsibilities:

  • Prepares source documents for Health Plan/Non-Plan Self-Pay for entry of billing information.

  • Reviews visit records, Ancillary Services and Emergency Room visit records; ensures source document includes essential information required for data entry (e.g. MR#, birthdate, address, group number, subscriber name, attending physician, date of service); researches missing information.

  • Codes CDM number of services provided; adjusts fees according to health plan benefits; applies prevailing rates for non-health plan patients.

  • Registers patient and guarantor in system; enters charges; verifies totals against source documents for all billable services, regardless of billing type.

  • Enters additional charges to patient accounts form source documents prepared by insurance clerk; performs insurance benefits maintenance; verifies proration of insurance; performs final billing; refers claims to insurance area as necessary.

  • Enters adjustments to patient accounts into computer from already prepared source documents.

  • Researches payer remittances for posting; determines patient account and proper insurance company/plan; determines contractual adjustments appropriate for insurance company/plan if underpayment or overpayment; transfers unidentified payments to suspense account; refers to supervisor or proper insurance area.

  • Posts remittances and contractual adjustments to patient account; performs accounts receivable transfer when necessary to show proper liability; verifies zero insurance balance after remittance posting; refers account to insurance area if necessary; initiates rebilling action if patient still bears liability after all insurance remittances received; verifies batch total of remittances posted or suspended.

  • Batches and files source documents for all data entry; assigns batch number for input and computer reports; verifies number and total for data entered.

  • Performs miscellaneous data entry as assigned (e.g. updating of patient information, CDM additions, statistical data entry).

  • Operates standard office equipment; maintains files and office supplies as necessary.

  • Demonstrates knowledge, skills, and abilities necessary to provide culturally sensitive care and/or service.

    • Qualifications:


    Basic Qualifications:

    Experience

  • Minimum one (1) year of data entry or related experience.

    • Education

  • High school diploma or GED.

    • License, Certification, Registration

  • N/A


    • Additional Requirements:

  • Type 40 wpm.

  • 10-key by touch.

  • Demonstrated knowledge of and skill in adaptability, decision making, customer service, oral communication, problem solving, systems thinking, teamwork, and written communication.

  • Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.


    • Preferred Qualifications:

  • Post high school coursework in medical terminology and bookkeeping.

  • Knowledge of CPT coding, accounts receivable, medical terminology and medical insurance benefits.
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    $38,472 to $54,214
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