Job Description

A top hospital system and healthcare provider on the west coast and in Kearny Mesa / San Diego area is looking for a Service Center Representative to join their Medicare and Special Projects team.

This is a complex role that will require critical thinking, computer skills, and the ability to make autonomous decisions.

The Service Center Rep will perform heavy data entry (80%) and outbound calls (20%) supporting health plan enrollment. The overall objective of this position is to perform the account maintenance, billing, reconciliation, reporting and / or customer service related activities.

Duties could include one or more of the following : 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 cards, to provide facilities support and to enter documents into the workflow imaging system.

Additional responsibilities of the Service Center Representative in the Medicare and Special Projects group will include but are not limited to :

• 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
• Resolving payment discrepancies and delinquencies
• 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

REMOTE :

• This position will be fully remote but the candidate must be able to work 8-5pm PST time zone.
• 100% attendance is required for the 7 week training

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.

We are an equal opportunity / affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

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Required Skills & Experience

2 years' experience with heavy data entry, background in accounting, finance, healthcare or insurance preferred

Proficient in data entry, spelling & grammar, typing, and basic mathematics

Demonstrated experience in Customer Service

Ability to diagnose, analyze and solve quantitative and qualitative problems

Strong business acumen and ability to communicate clearly and professionally

Experience with PC window-based computers

Ability to work in a fast paced environment with strong attention to detail

Ability to learn and adapt to new business requirements, flexible to change

New graduates welcome!

Nice to Have Skills & Experience

• Bachelor's degree
• Prior Healthcare related field BG
• Account, Finance, Banking, etc experience
• Previous experience in roles that involves complex problem solving including billing related issues.
• College grads : Good GPA and high test scores

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching.

Employees in this role are also entitled to paid sick leave and / or other paid time off as provided by applicable law.