Medical Transportation Analyst UHW

Job Summary: Performs prospective review, ordering, analysis and reporting of KP medical transports. Interacts with staff and physicians to answer inquiries and educate on covered benefits. Interacts with staff and members in pre-service denials processing. Records patient demographic and medical information and reports the information to designated medical transportation dispatching. Essential Responsibilities: Reviews physician and staff request for benefit-covered medical ambulance service. Ensures that information is documented and reported following appropriate guidelines and procedures. Utilizes various data systems to obtain the medical transportation program information and to produce contractual and utilization reports as requested. Investigates medical transports that are completed inappropriately to determine the cause, to problem solve, and to notify the Medical Transportation Supervisor. Demonstrates awareness of and adherence to policies, procedures, and requirements of regulatory agencies. Responds to requests for medical ambulance service through designated dispatching areas in an accurate and timely manner. Issues as appropriate pre-service Notice of Non-Coverage letters in accordance with regulatory requirements. Provides supporting documentation and distributes letters to the appropriate individuals and/or agencies. Verifies health plan membership status. Attends mandatory department meetings and performs miscellaneous duties as assigned by the Medical Transportation Supervisor. Basic Qualifications: Experience Minimum six (6) months experience required in a health-care related field. Per the National Agreement, current KP Coalition employees have this experience requirement waived. Education High School Diploma or General Education Development (GED) required. License, Certification, Registration N/A Additional Requirements: Ability to effectively coordinate multiple tasks. Working knowledge of medical terminology required. Excellent verbal and written communications skills. Strong customer service skills. Must be able to work in a Labor/Management Partnership environment. Preferred Qualifications: EMS or hospital dispatch experience. Knowledge of PC and Kaiser mainframe systems. Knowledge of KFHP coverage benefits, state, federal and local regulatory agency requirements. Notes: This is a temporary position for approximately three (3) months. Rotating weekends PrimaryLocation : California,Tustin,Tustin Home Health HoursPerWeek : 40 Shift : Day Workdays : Sun, Mon, Tue, Wed, Thu, Fri, Sat WorkingHoursStart : 09:00 AM WorkingHoursEnd : 05:30 PM Job Schedule : Full-time Job Type : Standard Employee Status : Temporary Employee Group/Union Affiliation : B01|SEIU|Local 399 Job Level : Individual Contributor Job Category : External Medical Services Department : Tustin Executive Center - Cost/Bene-Ambulance Hub Ops - 0808 Travel : No Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status. For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment: Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and proced…

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