Account Administration Representative

Kaiser Permanente; San Diego (CA); On-site; USD 42,000 - 62,000; Full time

Job summary

Kaiser Permanente in California seeks a team-oriented member of the Membership Accounting and Contracts Administration function. The role covers account maintenance, billing, reconciliation, reporting and customer service related activities, along with data entry, MRN handling, contract issuance and imaging workflow support.

Responsibilities include ensuring correct billing, processing enrollments and terminations, auditing purchasers, and producing reports.

Qualifications

• Proficiency in math, data entry, typing, spelling and grammar, for which test 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.

Responsibilities

• Identify, research and reconcile billing payments to ensure accurate eligibility, payment, revenue and membership records.
• Set up and maintain member data including enrollments, corrections, retroactivity adjustments and terminations.
• Support eligibility inquiries.
• Ensure bills are correct and mailed timely.
• Interact with purchaser benefit administrators to explain policy and contractual provisions.
• Resolve related problems.
• Assist Health Plan purchaser contacts and sales staff in the sales process and problem resolution.
• Conduct audits of purchasers with large payment variances or unallocated payments.
• Resolve payment discrepancies and delinquencies.
• Ensure purchasers’ compliance with policies and contracts.
• Prepare reports and manage purchaser correspondence.

Skills

Math proficiency

Data entry

Typing

Spelling and grammar

Team player

Customer service

Windows PC experience

Tools

Windows PC

Job description

Job Summary:

To work as a team member of the California Service Center (CSC) which is the Membership Accounting and Contracts Administration functions for the California Division. The overall objectives of this position is to perform the 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 contracts 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 on a 24 hour per day, 7 day a week basis.
• 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

• N/A.

License, Certification, Registration

• N/A

Additional Requirements:

• Proficiency in math, data entry, typing, spelling and grammar, for which test 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 of two (2) years 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