Provides support for member correspondence activities, including generating clinical determination letters for members and providers and following established guidelines and standards related to correspondence processing. Contributes to the organization’s goal of providing quality, cost-effective member care.
Responsibilities include:
- Assist with generating clinical determination letters to members and providers, ensuring clarity, accuracy, and compliance with required reading grade levels.
- Collaborate with internal teams to ensure correspondence meets regulatory requirements, including plain language and proper format.
- Monitor letter queues to support timely generation and delivery of correspondence.
- Respond to inquiries and assist with troubleshooting issues related to letter creation or delivery.
- Support feedback processes to improve letter accuracy, quality, and consistency.
- Maintain strong attention to detail when processing letters to meet company and regulatory standards.
- Develop a basic understanding of healthcare programs, processes, and related software systems.
- Support internal teams, including both technical and non-technical staff, to ensure proper letter production.
Requirements & Qualifications
- At least 1 year of experience in an administrative support role, preferably within a healthcare environment supporting correspondence or clinical communications, or an equivalent combination of education and experience.
- Previous experience as a Correspondence Processor at Molina preferred.
- Strong attention to detail and ability to work within regulatory and internal requirements for letter generation.
- Strong organizational and time-management skills with the ability to manage multiple queues and deadlines.
- Excellent verbal and written communication skills.
- Willingness to learn and adapt to new programs, software systems, and lines of business.
- Ability to research, obtain feedback, and incorporate necessary adjustments into letters.
- Ability to manage multiple tasks simultaneously while maintaining quality and compliance.
- Ability to maintain confidentiality and follow applicable guidelines, regulations, and policies.
- Ability to work effectively in a fast-paced, high-volume environment.
- Ability to collaborate effectively with team members and internal departments.
- Basic proficiency with Microsoft Office and applicable software programs.
Location
N/A
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago
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