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Kaiser Permanente Careers

Insurance & Claims

Delivery You Can Count On

As a member of our Claims Connect team, you'll help process and deliver the claims information Kaiser Permanente's members, providers, regulators, and customers need, and expect, from a world-class health care organization.

Employer & Broker Services Specialist

Location: Burbank, CA Additional Locations:

Empire Corporate Plaza 10740 4th St., 10740 4th St., Rancho Cucamonga,California, 91730
Job Number: 773622 Date posted: 02/22/2019

The Employer and Broker Specialist supports growth and retention of members in the region by: 1) Providing one-contact resolution to escalated employer and broker concerns that requires the application of considerable discretion and independent judgment to evaluate various courses of conduct, formulate solutions, and negotiate resolution that binds KP and departs from prescribed standards 2) Analyzing patterns and trend data regarding employer and broker concerns and needs 3) Formulating recommendations to improve and sustain effective purchaser relationships.

Essential Responsibilities:

  • Retention & Growth Opportunities: Identify growth & benefit expansion solutions to better meet purchaser health care needs Report trends around issues groups are experiencing to the account management team to inform strategic account engagement and renewal planning.

  • Process Improvement & Data Analysis: Identify, analyze & report trends and/or systematic issues as they become apparent. Provide consultation and recommendations to management around process improvement opportunities & solutions. Participate in policy formulation around service issue areas.

  • Research & Resolution of Employer & Broker Initiated Issues: Formulate solutions to complex and sensitive employer-initiated and broker-initiated concerns, using considerable discretion and independent judgment. Investigate circumstances surrounding purchaser issues and evaluating various courses of conduct. Negotiate reasonable and contractually defensible resolution of purchaser issues by weighing conflicting information (regulations, legal principles, and regional goals), departing from prescribed standards and binding KP.

  • Issue Entry & Documentation: Log issues received and maintain updated status of resolution in the system of record. Ensure accurate and complete data is entered into the correct business applications.

  • Knowledge & Professional Development: Complete required training around health plan products and processes. Stay current on applicable laws and regulations. Pursue opportunities to continuously develop skills.

  • Basic Qualifications:


  • Minimum four (4) years in a health care, health insurance, or sales and marketing environment.

  • Minimum two (2) years of working directly with customers by phone, email and/or in person providing information and resolving issues.

  • Education

  • Bachelor's degree OR four (4) years of directly related experience required.

  • High School Diploma or General Education Development (GED) required.

  • License, Certification, Registration

  • N/A

  • Additional Requirements:

  • Background experience in brokerage/consultant, insurance carrier, TPA, or benefits administration.

  • Knowledge of health plan information system technologies including but not limited to: Claims, Membership, Care Delivery, Sales Force, Customer Relationship Management, Case Management.

  • Ability to analyze processes, identify and implement process improvements, and manage targeted implementations.

  • Demonstrated understanding of current / future trends and changes in healthcare / health insurance laws / regulations.

  • Demonstrated understanding of competitor's strengths, weaknesses and strategies.

  • Ability to analyze quantitative and qualitative data.

  • Demonstrated ability to deliver recommendations and presentations to management.

  • Ability to communicate effectively and courteously with customers.

  • Ability to apply judgment and make autonomous decisions to quickly resolve issues on behalf of client.

  • Demonstrated expertise in dealing with difficult situations.

  • Demonstrated strong organizational skills, problem solving, interpersonal skills, independence and initiative.

  • Effective written and verbal communication skills.

  • Proficiency in computer and analytic skills

  • Strong knowledge and experience in using multiple client databases & systems

  • Preferred Qualifications:

  • Experience in customer service, enrollment, billing, claims processing, sales, account management or health plan administration in healthcare or health insurance industry preferred.
  • Primary Location: California,Burbank,Marketing Sales Service and Admin 3100 Thornton Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:00 AM Working Hours End: 5:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: Insurance / Claims Department: Employer and Broker Services Travel: Yes, 5 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    About Insurance & Claims Careers

    Careers in Insurance & Claims

    Our insurance and claims teams are committed to meeting customer and member expectations when it comes to the timely and accurate processing of claims, while remaining in compliance with federal, state, and local laws, as well as regulations and rules. Make an impact as you contribute to the implementation of contemporary technology in areas such as claims quality, claims operations, business analysis, processing, configuration, reporting, and more.

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