Account Administration Representative

Kaiser Permanente; Denver (CO); On-site; USD 37,000 - 50,000; Full time

Job summary

Kaiser Permanente in Colorado is seeking an Account Administration Representative to support billing, enrollment, and member data activities. You will perform payments research, data maintenance, and customer service across contracts and purchaser inquiries.

The role involves processing enrollments, handling corrections, and generating reports, with attention to eligibility, balances, and documentation. A strong team player is essential for success in a fast-paced healthcare environment.

Qualifications

• High school diploma or GED required.
• Demonstrated ability to work in a team-based environment.
• Excellent communication and customer service skills.
• Ability to diagnose, analyze and solve a variety of problems.

Responsibilities

• Identify, research and reconcile billing payments amounts to ensure accurate eligibility, payment, revenue and membership records.
• Set up and maintain member data including processing enrollments, corrections, retroactivity adjustments and terminations.
• Support eligibility inquiries.
• Ensure bills are correct and mailed timely.
• Prepare reports and manage purchaser correspondence.

Skills

Teamwork

Customer service

Problem solving

Communication

Computer skills

Education

High School Diploma or GED

Tools

Printers

MVS/ESA

JES2

Mainframe

Tape management

Job description

• May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement. Please refer to the respective collective bargaining agreement for additional information on such wage premiums: https://www.lmpartnership.org/local-contracts.

• May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement. Please refer to the respective collective bargaining agreement for additional information on such wage premiums: https://www.lmpartnership.org/local-contracts.

Job Summary

Performs account maintenance, billing, reconciliation, reporting and customer service related activities. Duties also include performing database maintenance and research tasks to support the contracts administration, cash control operations and assignment of medical record numbers, to generate and distribute contracts and member I.D. cards, to provide facilities support and to enter documents into the workflow imaging system.

Essential Responsibilities

• Identifying, researching and reconciling billing payments amounts to ensure accurate eligibility determination, payment, revenue and membership records.
• Setting up and maintaining member data including but not limited to processing enrollments, corrections, retroactivity adjustments and terminations.
• Supporting eligibility inquiries.
• Ensuring bills are correct and mailed timely.
• Interacting with purchaser benefit administrators to answer questions and explain Health Plan policy and contractual provisions related to membership and billing. Resolving related problems.
• Assisting Health Plan purchaser contacts and sales and service representatives in the sales process and the analysis and resolution of problems related to membership accounting.
• Conducting audits of purchasers with large payment variances, unallocated payments or other specified criteria. Resolving payment discrepancies and delinquencies.
• Ensuring purchasers compliance with Health Plan policies and contractual provisions.
• Preparing reports and managing purchaser correspondence.
• Receiving, entering data, reviewing, researching balancing, and applying daily purchaser deposits and sources from the bank in a timely and accurate fashion.
• Assisting with the production and distribution of payment-related reports required by purchasers and management, and by operating and maintaining printers and other related peripheral equipment.
• Supporting Medicare processing and reporting requirements.
• Ensuring that changes to contract are quickly and accurately updated in the contract systems.
• Assisting with the production and distribution of contracts and related notices for new and renewing purchasers and individuals.
• Answering, researching, issuing and resolving problems related to medical records numbers (MRN) and performing any required follow up activities.
• Processing purchasers eligibility reported electronically by coordinating the exchange of media with groups and Information Services, resolving problems, maintaining and operating related equipment and maintaining supporting logs/records.
• Identifying, coding, batching, scanning and indexing documents for imaging.
• Providing office services support including but not limited to picking up, sorting and delivering mail, filing and retrieving documents, ordering and distributing office supplies, performing miscellaneous facilities maintenance tasks and providing photocopying and copier maintenance.
• Working with internal and external customers and vendors to resolve any issues related to support services activities.
• Collecting and monitoring productivity and customer service quality measures.
• Participating team-based projects and contributing to customer service and operations improvements initiatives.
• Assisting with training as required.
• Facilitating communications across all lines of business and with other Kaiser Permanente departments.
• Participating in purchasers performance evaluations and performance target setting activities.
• Perform other duties as they are assigned.

Experience

Basic Qualifications

• N/A

Education

• High School Diploma OR General Education Equivalency (GED) required.

License, Certification, Registration

• N/A

Additional Requirements

• 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.
• Testing Required: Account Administration Representative Assessment with a passing score - 31st Percentile or higher.

Preferred Qualifications

• Minimum of three (3) 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.
• Accounting, bookkeeping and/or finance coursework preferred.

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.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

Primary Location: Colorado,Denver,Regional Office - Colorado

Scheduled Weekly Hours: 40

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri

Working Hours Start: 08:00 AM

Working Hours End: 04:45 PM

Job Schedule: Full-time

Job Type: Standard

Worker Location: Flexible

Employee Status: Regular

Employee Group/Union Affiliation: C01|SEIU|Local 105

Job Level: Entry Level

Department: Lowry Administrative Offices - National Services - 1608

Pay Range: $26.63 - $36.14 / hour

Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Travel: No

Work Setting: Flexible

Worker location must align with Kaiser Permanente's Authorized States policy.

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.