To provide Workers compensation representation in the medical office setting and act as a liaison between Occupational Health and internal and external customers. Handles patient registration and check-in. Provides telephone reception and appointing services for the patient in accordance with regional policies and procedures. They work directly under the supervision of the Manager and in collaboration with the Health Care Team.

• Maintain working knowledge of departmental policies and procedures. Maintain working knowledge of employer/insurer contracts to ensure contractual obligations are met. Master, exhibit and maintain proficient skills in the extensive use of multiple computer systems, including but not limited to: Healthconnect and Agility. In a professional manner manage multiple tasks simultaneously during constant prioritizing of work load and while working with numerous interruptions, some of which may be confrontational.


• Respond to requests for relevant medical treatment information to insurers, case managers and attorney representatives while simultaneously insuring patient confidentiality within current federal laws, workers comp laws and Kaiser Permanente policies. Track and assure receipt of all reports/records from outside providers relevant to injured workers. Function at all times when interacting with all contacts in a service oriented manner that promotes customer satisfaction. Messaging: Review medical chart to collect information for messages to send to health care team. Routes incoming calls from patients, physicians, nurses and other departments according to scripts and guidelines. Forwards medical and other complex inquires to appropriate personnel. Take messages as necessary. Manage electronic in-basket in multiple system applications.


• Assist and educate injured workers in person or by phone with information and available resources related to workers compensation . Direct injured workers to appropriate resource within our Program.


• Appropriately document employment information and date of injury in Healthconnect.


• Identify and report organization policy/procedure inconsistencies. Recognition and resolution of complex problems. Maintain professional appearance at all times.


• Appointing: Review medical chart to appoint according to scripts and guidelines. Assist with Scheduling/rescheduling/canceling appointments for services, according to scripts and guidelines.


• General Services: Assist patients by providing phone numbers, facility directions and office layouts; directing to other departments and administrative services for further information, for example (but not limited to) Membership Services, Dental and Pharmacy. Handle ingoing and outgoing departmental mail and correspondence with patients.


• Perform other duties as requested.

• Minimum one (1) recent medical office setting or related insurance experience.

• High School Diploma or General Education Development (GED) required.

• N/A

• Medical terminology/anatomy computer application.


• Clear communication skills both written and verbal.


• Excellent customer service skills.


• Demonstrated record of dependability and documented good attendance.


• Manage multiple tasks simultaneously during constant prioritizing of workload.


• Working with numerous interruptions, some of which may be confrontational.


• Assist with claim scenarios.


• Continuous review and prioritizing of large volume of work.

• Two (2) years prior medical office experience in a hospital or medical office setting with some billing experience; OR


• Two (2) years prior working experience in workers compensation.


• Working knowledge of Kaiser Permanente organization policies/procedures and health plan coverages/benefits.


• Working knowledge of Kaiser Permanente computer systems and applications.


• Working knowledge of business office practices.


• Basic knowledge of office equipment, i.e. Fax machine, photo-copier, printer, etc.

Notes:

• Travel locations: OJS (San Rafael) and OJC (Columbia Tech)