Membership Liasion

Kaiser Permanente Honolulu, HI December 22, 2016 Information Technology

Develops positive relationships with business, government, labor and other external customers in terms of enhancing customer servicing. Analyzes, compiles, and prepares data for clear, concise presentations to internal and external customers. Trains, orients, and monitors Consolidated Service Center personnel. Enhances goodwill towards Kaiser through handling of group problems and request for information and materials. Implements and maintains activities of Membership Accounting including billing and reconciliation processing of revenue and reported membership.

Essential Responsibilities:

Represents Kaiser Permanente with various member and groups. Manages assignments by analyzing situation, developing strategies with groups, and recommending solutions. Engages in presentations to group on KP reconciliation, policies and procedures and to educate group and member.

Establishes and maintains working relationships with Regional internal departments and Consolidated Services Center (CSC) in order to improve processes and outcomes surrounding group reconciliation and membership information processing.

Supports needs of market development and other areas for new products.

Coordinates efforts to implement EDI (Electronic Data Inter-change) in development and maintenance for commercial group set-up. Works with Health Plan Representatives, IT, FASD and CSC to automate enrollment/payment processes in CMS.

Audits and reconciles major group accounts. Identifies problems with accounts and prepares adjustments as required. Notifies supervisor of unusual occurrences and recommends appropriate actions.

Receives, processes, and resolves complaints, problems and other special needs for group and members. Uses and develops automated tracking system to record and manage group and/or member information.

Serves as a resource regarding group and/or member issues as related to membership accounting processes. Assists supervisor and others in analyzing contacts and service recovery. Makes recommendations for changes in order.

Qualifications

Basic Qualifications:

Experience

Minimum one (1) years of computerized accounting experience in health insurance environment including account audit experience.

Minimum two (2) years of direct (in person) public contact experience, preferably in Health Care or HMO.

Education

Bachelor’s degree with major in accounting, business, or related field OR four (4) years of experience in a directly related field.

License, Certification, Registration

N/A

Additional Requirements:

Extensive knowledge of health insurance enrollment.

Demonstrated experience in working with customers to resolve complex issues, while maintaining effective working relationships and promoting good public relations.

Demonstrated ability to resolve problems related to premium billing and enrollment.

Ability to develop and understand Kaiser Permanente group billing process.

Demonstrated knowledge of and skill in oral communication, written communication, group presentation, problem solving, conflict resolution, customer service and interpersonal relations.

Demonstrated knowledge of and skill in word processing, spreadsheet and database PC applications.

Preferred Qualifications:

Minimum two (2) years of direct (in person) public contact experience in health care or HMO.