Sr Coordination of Benefits Specialist in Englewood

Full-time @Kaiser Permanente in Healthcare
  • Englewood, Colorado View on Map
  • Apply Before : September 30, 2022

Job Description

Join healthcare leader Kaiser Permanente as Sr Coordination of Benefits Specialist in Englewood. Read role and responsibility to apply Kaiser Permanente is careers in Englewood Colorado.

 

Position : Sr Coordination of Benefits Specialist

Location :  Englewood, Colorado

Job Type : Full-time

Job details:

Description:
This role with the Coordination of Benefits team serves as the primary resource to internal/external customers requiring investigation, identification, and validation of non-KP medical coverages. The analyst is responsible for entering valid coverages into KP’s Tapestry system and making timely and accurate primacy determinations for claims payments, according to Federal and State regulations, national guidelines, and internal policy. The analyst’s actions play a critical role in pre-pay avoidance and post-pay recoveries savings on behalf of the organization.

This role also includes participation in process improvement and process management activities such as planning, performing, and implementing improvement initiatives.  Partners with management, project champions, and process owners to execute projects and deliver results. Participation in training initiatives to include development of training tools and leading internal staff trainings related to COB.

Business Consulting: includes analysis/evaluation of business and/or system process and functional requirements, development of business cases, client support during system development and implementation, development and maintenance of service level agreements. Develops relationships with upstream and downstream business partners. Develops/maintains and changes business processes, and understands the business processes of assigned partners and how they relate to our functional areas. Develops and recommends changes to business processes.

Essential Functions:

• Full use of application of standard principles, theories, and techniques.

• Uses professional concepts and company policies and procedures to solve a wide range of difficult problems in imaginative and practical ways.

• Develops and leverages relationships with peers, supervisors and management.

• Understand their functional area business processes and assigned area.

• Independently initiates, investigates, documents, and analyzes client requirements in project areas such as: new/existing business operating models with innovative approaches to solutions support, market research of emerging or available product functionality and operational readiness assessment.

• Assesses scope and impact of client business needs.

• Develops business cases with cost, service, and benefit dimensions of proposed projects that are used at management and executive levels for funding and scope decisions.

• Conducts and/or participates in the analysis of client business processes and functional requirements and in the preparation of appropriate documentation to communicate and validate the information.

• Conducts workflows, process diagrams and gap analysis.

• Identifies overlaps and related processes.

• May assist in the development of project plans.

• May use the associated project planning tools.

Basic Qualifications:
Experience
– Minimum three (3) years of experience, to include a minimum two (2) years in a consulting role.
Education
– Bachelor’s degree in business/health care administration or related discipline 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:
– Identifies and documents cross-functional and/or cross-divisional, functional requirements, workflow, information sources and distribution paths, and system/process specifications.
– Thorough knowledge of platforms of the assigned functional area.
– Must be able to work in a Labor/Management Partnership environment.
 
Preferred Qualifications:
– Bachelor’s degree in business/health care administration or related discipline.
– Certification or advanced qualification by third party association that matches the function or field applicable to the business discipline preferred.

 

Other Details

Primary Location: Colorado,Englewood,Meridian – Englewood MSSA

Scheduled Weekly Hours: 40

Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM

Working Hours End: 05:00 PM

Job Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee

Job Level: Individual Contributor

Department: Englewood MSSA Claims – National Claims Service Org – 0315

Travel: No

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.

 

Career Tag :  Kaiser Permanente Jobs in Englewood, Kaiser Permanente career in Englewood, Kaiser health jobs in Englewood, Healthcare jobs in Englewood Colorado, Jobs in Englewood Colorado, Englewood jobs, Hiring nearby in Englewood Colorado

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