Account Administration Representative

Kaiser Permanente; Denver, Northern (CO, KY); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Kaiser Permanente in Denver area seeks an Account Administration Representative to handle billing, account maintenance, and related research tasks across contracts administration and cash control. The role supports Medicare processing, purchaser communications, and data entry with a focus on accuracy and timely processing.

You will work in a team-based environment, require a strong customer service background, and will engage with health plan policies and contractual provisions while learning

Qualifications

• High School Diploma or GED required.
• Demonstrated ability to work in a team-based environment.
• Successful customer service track record.
• Ability to diagnose, analyze and solve quantitative and qualitative problems.
• Clear and professional communication skills.
• PC Windows-based computer experience preferred.
• Willingness to learn new tasks and adapt to changing requirements.
• Excellent conflict resolution and decision making abilities.
• Ability to multitask across priorities.
• Account Administration Representative assessment with 31st percentile+ required.

Responsibilities

• Perform account maintenance, billing, reconciliation and reporting.
• Handle enrollment processing, terminations and retroactivity adjustments.
• Assist with eligibility inquiries and purchaser communications.
• Ensure bills are correct and mailed timely.
• Support sales, service and purchaser interactions and problem resolution.
• Audit purchasers with payment variances and resolve delinquencies.
• Ensure compliance with Health Plan policies and contract provisions.
• Produce and distribute reports and maintain related logs.

Skills

Customer service

Teamwork

Problem solving

Communication

Data entry

Microsoft Windows

Multitasking

Adaptability

Conflict resolution

Education

High School Diploma or GED

Tools

Mainframe systems

JES2

MVS/ESA

Printer hardware

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.

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.

Basic Qualifications:

Experience

• 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.