Temika Brown

Call Center Agents to support its contract with the Integrated Referral Management and Appointing Center (IRMAC),
the National Capital Regions’ premier coordinating authority for appointing and referral management. Responsible for
coordinating healthcare appointments for primary care and specialty care medical services via incoming and outgoing phone
calls for (13) Military Treatment Facilities within the National Capital Region. Utilize the AVAYA automated Call Distribution
(ACD) system, receive phone calls for appointment related requests for the National Capital Region and the Proactive line/
POM. Accurately and courteously schedule medical appointments, validating and documenting patient eligibility for services
from phone calls, or other methods used for appointment request. Supports the Primary Care Manager (PCM) by name
processing for appointments and appropriate access to care timeframes allocation of standard appointment types.

• Works closely with internal/external customers to meet their health information management needs as it relates to release
  of protective health information via paper and electronic media.
  ● Has a solid knowledge/understanding of HIPAA privacy and security issues as it relates to release of information, and/or
  other regulations related to protective health information.
  ● Reviews release requests for appropriateness and validate the authorization by photo identification.
  ● Serves as inter and intra department resource for the other staff members, answering questions and providing instructions
  as necessary.
  ● Monitors printers for incoming documentation and process paperwork in a timely manner.
  ● Collects loose filing/scan documents from clinical area twice daily, ensuring that a medical record number is placed on each
  document.
  ● Opens departmental mail and sorts; forwards mail appropriately to document preparation station or other clinical units, as
  necessary.
  ● Verifies patient identity and process same day Release of Information Request via KP HealthConnect EMR.
  ● Requests patient charts by accessing the appropriate system.
  ● Responds to inquiries from patients and staff members and instructs them in the appropriate methods for requesting
  records.
  ● Enters data into disclosure accounting system in accordance with HIPAA standards.
  ● Corrects errors and incomplete information on forms as necessary when requested by a supervisor or physician.
  ● Completes simple forms as set forth on the MEA Approved Forms list, maintained by the HIMS Department.
  ● Runs delinquency report from HealthConnect and resolves open items on that report with physicians in the assigned MOB.
  ● Assists members in a professional manner that promotes a positive customer service experience.
  ● Provides members with general information, and/or refer them to appropriate department as necessary.
  ● Responds to member inquiries related to changes or corrections to demographic information and PCP assignment and
  center changes.
  ● Initiates member issue to fix when one member has two different medical records.
  ● Documents compliments in Macess.
  ● Orders HIPAA Certifications.
  ● Validates basic benefit information related to copay, co-insurance, deductibles and other KP plans.
  ● Documents member inquiries in CHATS.
  ● Performs referral status look-up in Healthconnect.
  ● Orders new or replacement IDs.
  ● Maintains knowledge and training (from KP Learn) on all information systems necessary to perform duties.
  ● Assists patients with navigating KP systems including kiosks and way-finding.
  ● Responds to voice mail in a timely fashion.
  ● Performs other duties as directed.
  ● Orients and trains new staff.
  ● Wears professional attire to include a KP-provided jacket.
  ● Performs the duties of the Receptionist and Administrative Assistants as necessary.

• Researched and responded to all department calls via inbound call center. Knowledge of CA and MAS regions. Handled and resolved
  escalation and complaint calls for providers and members via call center escalations team. Assisted patients in obtaining medical
  services throughout the Kaiser Permanente HMO and network affiliates. Reviewed medical claims for providers & members and
  provided callers with the appeals process when needed. Assisted external and internal providers and members with appeal status.
  ● Knowledge of HMO/managed care, PPO, and COBRA insurance industry and medical claims. Knowledge and understanding of
  Medicare & Medicaid (CMS), HMO plans, and of HIPPA regulations.
  ● Supported KP internal departments with member benefits, plan, or facility information.
  ● Met or exceeded all performance metrics including handle time, available time, quality assurance score, and customer survey
  score.
  

Knowledge of scheduling surgeries for pediatric patients and prepare all surgery documents. Ensure accuracy of scheduling patients
using the applicable scheduling system for the department. Schedule routine and add-on exams; schedule complex radiological
exams prior to the patient's arrival or on the day of surgery. Update scheduling systems with cancellation and no shows by COB and
reschedule canceled appointments for patients who did not show or for ancillary services cancellations by providers. Scheduled
follow-up post op appointments. Assisted the receptionist/front desk when needed by greeting patients and parents courteously.
Obtain required consents for department & ensure distribution. Respond to patient portal work lists (i.e., appointment requests, fax
queues, email requests, etc. May include messaging center work lists in the future).
● Surgery scheduling knowledgeable.
● Medical terminology knowledgeable
● Lead staff events to improve the customer experience and staff morale.
● Collect and record co-payments and deposits. Responsible for helping department meet 85% of the collection target.