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Accounting, Actuarial & Finance

Support the Bottom Line — and the Big Picture

Create the financial strategies that affect our patients, medical centers, and future. On this team, you'll provide the strategy recommendations that drive operational and process improvement, as well as face challenging opportunities to influence the future of health care.

Credit Specialist

Location: San Diego, CA Additional Locations:
Job Number: 871914 Date posted: 03/12/2020
Description:

The recovery specialist is responsible for managing outside provider relationships to ensure that internally identified overpaid claims are promptly recovered or closed within the guidelines of the department.  By utilizing a workflow management tool, the recovery specialist will be accountable for an assigned provider (non-Kaiser Permanente hospital) portfolio. Establishing relationships and understanding of root cause of overpayments is essential for the success of this role.  A strong working relationship with the National Claims Administration Department is a vital component in that success. 


To manage the quality and timeliness of credit and collection processes. To gain valuable insight into the group credit risks in the group Dues receivable portfolios and the Provider Overpayment identification and collection processes in the Claim Processing Centers. This Department leverages both transaction level information as well as powerful financial analytics to professionally collect monies owed Kaiser Permanente, The Credit Department continually seeks to gain a higher level of financial transparency of the credit, collection, receivable and provider overpayment portfolios. Critical management reporting functions include: continuous account monitoring, predicting bad debt exposure, proactive risk analysis, payment terms analysis and Premium/Provider Overpayment management. The Credit department is responsible for providing consultative leadership in; establishing and maintaining strong internal controls over the credit and collection processes; assuring integrity of the credit and collection data bases and publication collection reports.


Essential Functions:

- Collections of Dues Receivable from terminated purchasers.
- Utilization of Outside Collection Agencies (OCAs) and outside counsel.
- Creation and monitoring of payment plans.
- Bankruptcy management including communications and filings with the court.
- NSF Check correspondence and collection efforts.
- Provide collection status and recommendations to Manager of California Collections.
- The Collection Specialist of the California Collections Department is responsible for effectively following the California Collection Processes after responsibility for the purchaser is transferred from the San Diego CSC.

Basic Qualifications:
Experience
- Minimum five (5) years of work experience.
Education
- Bachelor's degree in related field, OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A
 
Additional Requirements:
- Excellent spreadsheet (Excel), word processing (Word), and database skills required.
- Excellent written and verbal communication and presentation skills required.
- Understanding of systems development life cycle, change control, quality assurance and database concepts.
- Must be able to work in a Labor/Management Partnership environment.



Preferred Qualifications:


- Minimum five (5) years of health care insurance industry experience highly preferred.

- Managing provider relationship on the recovery efforts of internally identified overpaid claims

- Performing root cause analysis and reporting findings for future avoidance

- Establishing working relationships with national claim administration department

- Accountable for performance metrics on assigned portfolio

- Maintain strong internal controls to insure the integrity of claim data is secured

- Provide MSSA Credit and Collection leadership status updates
Primary Location: California,San Diego,California Service Center - Rio S.D. 8954 Rio San Scheduled Weekly Hours: 40 Shift: Day Workdays: Monday - Friday Working Hours Start: 8:00AM Working Hours End: 4:00PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: Accounting, Finance and Actuarial Services Department: MSSA Credit and Collections 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 Accounting, Finance, & Actuarial Careers

Accounting Careers

Members of our accounting team support corporate projects and lend insight to areas such as financial reporting, tax planning and preparation, and audit management. This team also includes our audit professionals, who partner with financial and operational groups across the organization to analyze budgets and streamline procedures.

Finance Careers

Supporting critical business functions such as financial services, national Medicare finance, strategic planning, auditing, and corporate finance, our finance professionals develop the strategies that enable us to meet our financial goals.

Actuarial Careers

Applying probability and statistics to the practical problems of insurance, our actuarial team performs a variety of duties, including calculating the cost of premiums and policy values, preparing statistical studies, and forecasting financial results.

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