To apply my skills in problem solving, detailed planning, and customer service, along with my diverse experience in health administration within Kaiser Permanente, towards the success of team projects.
Financial Analyst December 2014 to CurrentKaiser Permanente － San Diego, CA
Kaiser Permanente Individual and Family Acting liaison between the line of business and key business partners, vendors for projects, process improvements and trouble issues Prepare business and financial reports for analysis and interpretation; Provide recommendations for future state based on analytic results Contribute to developments within operations, including training and communication Projects: California Assembly Bill AB2470 - Update the delinquency cycle during billing period in compliance with AB2470 regulations Finalize grievance process for AB2470 Request for Review.
Dual Coverage California and Regions outside California (ROC) Update the Dual Coverage process in compliance with regulatory Reformat Dual Coverage reporting Evidence of Coverage (EOC)/Plan Change Create development for an EOC when plan changes occur Align business process with Member Services and Member Administration during EOC interim process Benefit Coliseum Identify rate discrepancies within Benefit Coliseum rate tool Collaborate to ensure successful implementation of upcoming 2016 rates Unit Base Team Contribute to internal process improvements Support management and co-lead when they are not present Policy and Procedures To create and maintain Policy and Procedures for KPIF Operations Participate in CSC work group to discuss compliance requirements in ongoing P&P reviews.
Administration Representative October 2011 to December 2014Kaiser Permanente － San Diego, CA
Medicare Account- Billing and Reconciliation Prepare, format and administer financial correspondences Comprehensive knowledge of Medicare law and regulations with membership enrollment procedures Identify and support developmental projects by implementing quality and process improvement tools.
Assist Team Lead in aging and work assignments to ensure processes are being done timely Assist Eligibility during Open Enrollment to ensure members get enrolled in a timely manner Projects: Social Security Administration (SSA) Financial Report Monitor standardized SSA reconciliation Identify, analyze, and problem solve payment mismatches from Center of Medicare to Kaiser Permanente.
Medicare Delinquency Report Provide thorough analysis of member's delinquency payments by following proper compliance guidelines.
Medicare Lean Transformation Transform Medicare operation by utilizing Six Sigma statistical tools Identify root causes and waste within Medicare business processes.
Provide and execute innovated ideas by utilizing Plan, Do, Check Act management method.
Administration Representative June 2007 to October 2011Kaiser Permanente － San Diego, CA
Direct Pay Accounts Extensive knowledge and skills with member enrollment and account changes Managed heavy customer service-oriented interactions and positive conflict resolution Prepared, formatted and distributed correspondence and reports Execute detailed billing reports with high customer satisfaction.
Receptionist September 2005 to May 2006EMD Bioscience － San Diego, CA
Worked closely with clients ensuring friendly customer service.
Utilized multi tasking skills by scheduling appointments for multiple EMD Bioscience executive associates.
Arranged invoices in a timely and organized manner.
Bachelor's Degree : Psychology, 2013University of Phoenix － San Diego, CAPsychology
Associate Degree : Culinary Arts, 2006The Art Institute of California － San Diego, CACulinary Arts
General Education, 2004Diablo Valley Community College － Pleasant Hill, CAGeneral Education
Jessica M. Wilkinson Team Manager Kaiser Permanente California Service Center 8954 Rio San Diego Drive San Diego, CA 92108 619-269-7398 Jessica.M.Wilkinson@kp.org Christina H. Rios Member Billing and Reconciliation Team Lead Kaiser Permanente California Service Center 8954 Rio San Diego Drive San Diego, CA 92108 619-252-1233 Christina.H.Rios@kp.org Kimberly J. Jones Service Optimization Leader Business Process Management, Service Strategy, and Process Optimization Kaiser Permanente Customer and Member Services 8954 Rio San Diego Drive San Diego, CA 92108
scheduling appointments, Billing, business process, business processes, conflict resolution, clients, customer satisfaction, customer service, financial, financial reports, Financial Report, interpretation, Team Lead, law, processes, process improvement, quality, reporting, Six Sigma