Outpatient Consultation Representative - Bilingual; English

Position Overview

Position: Outpatient Consultation Representative - Bilingual (English/Spanish) Preferred

Department:

Requisition Number:

Kern Medical, a community cornerstone since 1867, is an acute care teaching center with 222 beds offering the only advanced trauma care between Fresno and Los Angeles. The hospital cares for 15,500 inpatients and 125,000 clinic patients annually. The role involves outpatient scheduling, insurance authorization, and registration functions to ensure timely and accurate patient care processing.

Key Responsibilities

• Submits necessary documentation to insurance companies to obtain required prior authorization for patient care and/or treatment.
• Tracks and follows up on outstanding requests for authorization.
• Answers patient phone calls, reviews processes, and schedules appointments for exams or follow-ups.
• Enters accurate patient demographic and insurance/payer information into the electronic patient record system and related applications.
• Screens referrals and informs referring physician offices, patients, and their families about hospital policies and payment options.
• Documents funding information and refers patients to financial counselors when necessary.
• Utilizes payer resources and websites to explore and assess eligibility.
• Assists with training of staff members and collaborates with outpatient scheduling and registration to resolve issues.
• Submits and responds to inquiries related to outpatient authorization and scheduling processes.

Incumbents are expected to bring or develop hospital/healthcare knowledge, understand the importance of accurate patient and insurance information, and use all available resources to ensure swift authorization approvals and continuity of care. Additional responsibilities include managing phone inquiries and coordinating appointments across various physicians, specialties, clinics, and locations.

Compensation & Additional Information

Estimated Pay: $23.06 to $28.36 per hour (includes a 6% premium pay).

Additional Compensation: This reflects only part of the total compensation package. Additional compensation may be available through differentials, incentives, bonuses, and participation with company contributions into the Kern County Employees’ Retirement Plan.

Benefits & Perks

• New Hire Premium: +6% of base rate of pay, matched up to 6% if contributed to the Deferred Compensation Plan.
• A Comprehensive Benefits Package including Holidays, Paid Time Off, Retirement, Medical, Dental, Vision, and Life Insurance.