To work as a team member of the California Srv Center (CSC) which is the Membership Accounting & Contracts Administration functions for the California Division. The overall objectives of this position is to perform the account maintenance, billing, reconciliation, reporting & customer srv related activities. Duties also include performing database maintenance & research tasks to support the contracts administration, cash control operations & assignment of medical record numbers, to generate & distribute contracts & member I.D. cards, to provide facilities support & to enter documents into the workflow imaging system.
Essential Functions:
Identifying, researching & reconciling billing payments amounts to ensure accurate eligibility determination, payment, revenue & membership records.- Setting up & maintaining member data including but not limited to processing enrollments, corrections, retroactivity adjustments & terminations.
- Supporting eligibility inquiries.
- Ensuring bills are correct & mailed timely.
- Interacting w/ purchaser benefit administrators to answer questions & explain Health Plan policy & contractual provisions related to membership & billing.
- Resolving related problems.
- Assisting Health Plan purchaser contacts & sales & srv representatives in the sales process & the analysis & resolution of problems related to membership accounting.
- Conducting audits of purchasers w/ large payment variances, unallocated payments or other specified criteria.
- Resolving payment discrepancies & delinquencies.
- Ensuring purchasers compliance w/ Health Plan policies & contractual provisions.
- Preparing reports & managing purchaser correspondence.
- Receiving, entering data, reviewing, researching balancing, & applying daily purchaser deposits & sources from the bank in a timely & accurate fashion.
- Assisting w/ the production & distribution of payment-related reports required by purchasers & management, & by operating & maintaining printers & other related peripheral equipment.
- Supporting Medicare processing & reporting requirements.
- Ensuring that changes to contracts are quickly & accurately updated in the contract systems.
- Assisting w/ the production & distribution of contracts & related notices for new & renewing purchasers & individuals.
- Answering, researching, issuing & resolving problems related to medical records numbers (MRN) & performing any required follow up activities on a 24 hour per day, 7 day a week basis.
- Processing purchasers eligibility reported electronically by coordinating the exchange of media w/ groups & Information Srvs, resolving problems, maintaining & operating related equipment & maintaining supporting logs/records.
- Identifying, coding, batching, scanning & indexing documents for imaging.
- Providing office srvs support including but not limited to picking up, sorting & delivering mail, filing & retrieving documents, ordering & distributing office supplies, performing miscellaneous facilities maintenance tasks & providing photocopying & copier maintenance.
- Working w/ internal & external customers & vendors to resolve any issues related to support srvs activities.
- Collecting & monitoring productivity & customer srv quality measures.
- Participating team-based projects & contributing to customer srv & operations improvements initiatives.
- Assisting w/ training as required.
- Facilitating communications across all lines of business & w/ other Kaiser Permanente departments.
- Participating in purchasers performance evaluations & performance target setting activities.
- Perform other duties as they are assigned.
Basic Qualifications:
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Experience- N/A.
- N/A.
- N/A
Additional Requirements:
- Proficiency in math, data entry, typing, spelling and grammar, for whichtest are required.
- Demonstrated ability to work in a team-based environment.
- Successful customer service track record.
- Ability to diagnose, analyze and solve a variety of quantitative and qualitative problems.
- Ability to communicate clearly and professionally.
- Computer experience preferably in a PC windows based environment.
- Willing to learn new tasks and adapt to new business requirements.
- Excellent conflict resolution and decision making capabilities.
- Ability to work productively at multiple tasks.
- Ability to adapt to change and be flexible in shifting priorities.
Preferred Qualifications:
- Minimum two (2) years of experience in accounting, finance or related field preferred.
- Experience with operations of peripheral equipment, such as printers or magnetic tape equipment, and knowledge of operating systems commands such as MVS/ESA and JES2 mainframe application, and tape management systems preferred.
- Experience with mainframe application and computer transaction processing preferred.
PrimaryLocation : California,San Diego,California Service Center
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 05:00 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : B06|OPEIU|Local 30
Job Level : Individual Contributor
Job Category : Accounting, Finance & Actuarial Services
Department : California Service Center No.1 - CA Commercial Membership Admin - 0315
Travel : No
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
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