Yvette Gasca

Under the direct supervision, performs pre-admits and admits based on doctor's orders. Directs visitors and patients to the appropriate area and answers phones. Interviews patient and/or their representative to obtain demographic and financial information. Identify available payer sources and records information required for admission and/or registration. Reviews and assists patients to complete all required documents for completeness and appropriate signatures. Verifies insurance eligibility and benefits. Collects any cost shares due to include but not limited to co-payments, deposits, share of cost (SOC) and deductibles. Initiates and collects financial documents in support of all billing activities. Document KPHC and other systems as appropriate. Assembles accurate and complete records; prepares identification armbands; receive and release patient valuables. Explain hospital rules and regulations. Generates and distributes documents/reports to appropriate departments. Complies with organizational and departmental policies and procedures.

Essential Functions:

• Interviews patient &/or representative, collects/records all required financial demographic information including but not limited to coordination of benefits (COB), third party liability (TPL)&workers compensation (WC).

• Verifies patient's identification&insurance eligibility/benefits.

• Notify insurance company of admission status.

• Obtains authorization/pre-certifications&required billing information from all identified payer sources for Medical Office/Hospital Services rendered.

• Coordinate&informs patients of required financial obligations.

• Collect any cost shares due to include but not limited to copayments, deposits, share of cost (SOC)&deductibles.

• Reviews all required documentation w/ patient, ensuring completion&obtain all necessary signatures.

• Accurately document all requisite information related to the admission&collection processes in KPHC&other systems as appropriate.

• Refers to Financial Counselors for patients having a financial obligation to Kaiser Permanente as necessary.

• Explains admission process, hospital regulations, policies&procedures.

• Contacts physician if additional information is needed.

• Prepares patient armbands.

• Create patient file w/ all necessary documentation for bill completion.

• Generate&distributes appropriate registration/admission documents.

• Secures&releases patient valuables for patients admitted into the hospital.

• Escorts or arranges escort of patients to assigned room or area.

• Performs pre-admission function including but not limited to surgery&labor&delivery cases; inputs required data for the anticipated admit list, balancing&checking for accuracy&completeness.

• Collaborates w/ physicians, nursing&other departments to facilitate admission&transfer

• Responsible for proper monetary transactions as it relates to assigned cash drawer.

• Prepares bank deposit slip&contacts security for escort to deliver bag containing shift deposits to the designated safe.

• Responsible for completing cash drawer transmittal forms, keeping designated dollar amount of money in the cash drawer daily&balancing out at the end of the shift.

• Research&reconcile cash drawer issues. Distributes related monetary documents as required&maintain/control of petty cash fund.

• Hospital cashiering/cash handling functions to include deposits, exchange&change fund functions, web declarations&other hospital cashiering functions as assigned.

• Manually estimate MOOP along w/ submitting refund request if necessary, review&maintain hospital exchange fund&petty cash transactions.

• Totals&reconciles, credit charges&payments on account w/ standard processing forms.

• Mails information as required.

• Provides co-payment history statements

• Review&complete accounts in work queue(s). Notify mgmt of any copay discrepancy.

• Consolidates or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases.

• Performs clerical duties as assigned, including but not limited to, filing, faxing, scanning, processing of mail, supplies, printing, answering&redirecting calls as needed for the department.

• Review various reports (census, unbilled, etc.)

• Provide front-end coverage to other functional areas w/in admitting&provide support to ancillary departments as necessary.

• Provides patient w/ appropriate documentation&information for Medical Financial Assistance Program (MFAP).

• Assist in Quality Improvement monitoring as necessary.

• Perform reception duties as required including but not limited to answering phones, calling patient family when necessary, greeting members at the Front Desk&relieving other clerks for breaks&lunch as appropriate.

• Work w/ financial counselor related to patient financial ability.

• Establishes&maintains courteous, cooperative relations when interacting w/ other personnel, Health Plan members&the public. Performs other duties as assigned by mgmt team &/or lead admitting clerk.

Transfer- Acts as first point of contact for Kaiser Permanente members/patients and assists members/patients through registration process under minimal direct supervision. Practices proper cash handling and reconciliation processes in accordance with established policies and guidelines. Member and patient needs should be the primary focus of one's actions; develops and sustains productive member/patient relationships. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs. Establishes and builds rapport and cooperative relationships with the public/members/ staff. Responds quickly to meet member/patient needs and resolve problems using good judgment. Functionality may differ based upon operational setting.

Essential Responsibilities:

Upholds Kaiser Permanente's Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.

Customer Service (Greeting, navigating, instructing/educating)

• Greets members/patients and provides reception services, to include directing and assisting members in navigating through the medical center. Provides wayfinding to appropriate care locations/departments as availability allows. Provides direction and instructional guidance to patients who are unable to perform check-in services independently via KP interactive and emerging technologies.
• Provides coordination of services to address member needs related to benefits, finance and other member services utilizing available technology.
• Provides reception for designated area(s); verifies patient's visit with pre- established appointment scheduling; registers patients; verifies and selects appropriate insurance coverage including confirmation of alternate insurance, and assists members at designated KP interactive and emerging technologies and on all Kaiser Permanente sponsored electronic devices and technologies.
• Provides patient information to family members, following established patient confidentiality guidelines.
• Provides patients with assistance and education with regard to the use of KP interactive and emerging technologies.
• Demonstrates flexibility when addressing various member issues and needs related to operations and member services.
• Follows KP Service Standards.

General Job Functions:

• Schedules member and non-member appointments and follow-ups, by telephone, mail, electronically or in person utilizing Kaiser Permanente's computer systems as directed by provider or pre-established protocol.
• Ensures current schedules are accurate, makes authorized changes as appropriate.
• Verifies members' benefits, notifies member of applicable cost share and updates patients' demographics information to include all patient registration and billing information. Escalate any issues as appropriate.
• Directs patients to waiting areas. Obtains relevant information to determine priority appointment time/date, confirms appointment changes due to cancellations and notifies patients of available alternate times, schedules/registers for follow up appointments, tests and procedures.
• Answers calls and relays messages to staff.
• Distributes questionnaires, various medical/authorization/insurance forms, patient communication materials, and completes statistical reports as requested.
• Provides patient instructions as appropriate.
• Performs related clerical duties as required, such as direct booking, copying, etc.
• Performs related clerical duties in support of Clinic Strategic Goals and Proactive Office Encounters.
• Provides telephone reception for designated area by screening and referring incoming calls to appropriate staff; takes and relays messages; gives out general or procedural information.
• May assist in orienting new employees.
• Maintains courteous relations with patients and staff.
• Follows Labor Management Principals.
• May perform other duties as required.

Cash Handling

• Follows Kaiser Permanente cash safeguarding and cash handling policies and procedures.
• Determines and collects appropriate payments for services and products (where applicable) rendered as required per health plan coverage and the established fee schedule; informs member of account balance information; collects and documents in the computer system receipt of a variety of financial and non-financial forms and reviews with members as appropriate; directs patients to waiting areas.
• Carries out appropriate cash control procedures of balancing total revenue received with computer system cash drawer to ensure accuracy; completes closing process in the computer system and deposits daily revenue securely in safe.

Additional duties for Service Representatives in Optical Services to include:

• Coordinates eyewear for delivery to patient.
• Communicates with the Optical Lab, Contact Lens Distribution Center, and other Optical Centers to manage eyewear order logistics

Assists with inventory control procedures

Additional duties for Service Representative in Laboratory to include:

• Explains proper specimen collection to members, rejects unsatisfactory specimens.
• Assures all pertinent information is entered into system during accessioning.
• Updates and maintains all necessary logs.
• Accessions laboratory requests in Health Connect/Laboratory Information System.
• Maintains all printers - sorts and distributes results from printer processing.

Performs pre-analytical phase testing by centrifuging, separating, bar coding and transporting specimens.

Under the direct supervision, performs pre-admits and admits based on doctor's orders. Directs visitors and patients to the appropriate area and answers phones. Interviews patient and/or their representative to obtain demographic and financial information. Identify available payer sources and records information required for admission and/or registration. Reviews and assists patients to complete all required documents for completeness and appropriate signatures. Verifies insurance eligibility and benefits. Collects any cost shares due to include but not limited to co-payments, deposits, share of cost (SOC) and deductibles. Initiates and collects financial documents in support of all billing activities. Document KPHC and other systems as appropriate. Assembles accurate and complete records; prepares identification armbands; receive and release patient valuables. Explain hospital rules and regulations. Generates and distributes documents/reports to appropriate departments. Complies with organizational and departmental policies and procedures.

Essential Functions:

• Interviews patient &/or representative, collects/records all required financial demographic information including but not limited to coordination of benefits (COB), third party liability (TPL)&workers compensation (WC).

• Verifies patient's identification&insurance eligibility/benefits.

• Notify insurance company of admission status.

• Obtains authorization/pre-certifications&required billing information from all identified payer sources for Medical Office/Hospital Services rendered.

• Coordinate&informs patients of required financial obligations.

• Collect any cost shares due to include but not limited to copayments, deposits, share of cost (SOC)&deductibles.

• Reviews all required documentation w/ patient, ensuring completion&obtain all necessary signatures.

• Accurately document all requisite information related to the admission&collection processes in KPHC&other systems as appropriate.

• Refers to Financial Counselors for patients having a financial obligation to Kaiser Permanente as necessary.

• Explains admission process, hospital regulations, policies&procedures.

• Contacts physician if additional information is needed.

• Prepares patient armbands.

• Create patient file w/ all necessary documentation for bill completion.

• Generate&distributes appropriate registration/admission documents.

• Secures&releases patient valuables for patients admitted into the hospital.

• Escorts or arranges escort of patients to assigned room or area.

• Performs pre-admission function including but not limited to surgery&labor&delivery cases; inputs required data for the anticipated admit list, balancing&checking for accuracy&completeness.

• Collaborates w/ physicians, nursing&other departments to facilitate admission&transfer

• Responsible for proper monetary transactions as it relates to assigned cash drawer.

• Prepares bank deposit slip&contacts security for escort to deliver bag containing shift deposits to the designated safe.

• Responsible for completing cash drawer transmittal forms, keeping designated dollar amount of money in the cash drawer daily&balancing out at the end of the shift.

• Research&reconcile cash drawer issues. Distributes related monetary documents as required&maintain/control of petty cash fund.

• Hospital cashiering/cash handling functions to include deposits, exchange&change fund functions, web declarations&other hospital cashiering functions as assigned.

• Manually estimate MOOP along w/ submitting refund request if necessary, review&maintain hospital exchange fund&petty cash transactions.

• Totals&reconciles, credit charges&payments on account w/ standard processing forms.

• Mails information as required.

• Provides co-payment history statements

• Review&complete accounts in work queue(s). Notify mgmt of any copay discrepancy.

• Consolidates or corrects duplicate accounts by using appropriate system functions. Enters account notes on patient cases.

• Performs clerical duties as assigned, including but not limited to, filing, faxing, scanning, processing of mail, supplies, printing, answering&redirecting calls as needed for the department.

• Review various reports (census, unbilled, etc.)

• Provide front-end coverage to other functional areas w/in admitting&provide support to ancillary departments as necessary.

• Provides patient w/ appropriate documentation&information for Medical Financial Assistance Program (MFAP).

• Assist in Quality Improvement monitoring as necessary.

• Perform reception duties as required including but not limited to answering phones, calling patient family when necessary, greeting members at the Front Desk&relieving other clerks for breaks&lunch as appropriate.

• Work w/ financial counselor related to patient financial ability.

• Establishes&maintains courteous, cooperative relations when interacting w/ other personnel, Health Plan members&the public. Performs other duties as assigned by mgmt team &/or lead admitting clerk.

transfer- ophthalmology: Under direct supervision, provides visitor & teleph1 reception for designated area; assists patients in obtaining medical services; schedules patients for medical appointments following established procedures and/or collects payments for services rendered.

Essential Functions:
• Upholds KP's Policies & Procedures, Principles of Responsibilities & applicable state, federal & local laws
• Greets members & provides reception services
• Collects payment for services rendered
• Schedules appointments
• Answers & returns teleph1 calls & messages
• Maintains equipment & supplies
• Performs assigned & routine clerical duties
• Establishes & maintains courteous, cooperative relations w/ the public, patients, & other personnel
• Promotes, ensures & improves customer service to internal/external customers by demonstrating skills which are consistent w/ the organization's philosophy of providing extraordinary customer relations & quality service
• May perform other duties as required