Sr. Correspondence Specialist

Maryland Heights MO 63043 St Louis 1 14100 Magellan Plaza

Job Description

Responsible for the implementation and maintenance of member and provider correspondence. This includes collecting letter requirements from clients, reconciling them with State, Federal and Accreditation requirements. The Senior Correspondence Specialist is responsible for letter configuration (plan IDs, statuses, etc.), User Acceptance Testing (UAT), Managing Projects and Issue Resolution, as well as contributing to Process Improvement initiatives. The Senior Correspondence Specialist monitors production systems to ensure letter quality and timeliness standards are met. Develop and maintain documented standards for quality and ensure documentation correlates with letter functionality.

With oversight from the compliance department, responsible for the development and maintenance of authorization and non-authorization correspondence utilized by NIA to ensure compliance with legislative requirements, accrediting bodies and other oversight organizations. Research regulatory data bases and incorporate regulatory requirements into member correspondence for NIA accounts. Interface with account counterparts to arrive at final versions of correspondence before being loaded into the IT system. Serve as member correspondence content expert for new business implementations and internal projects such as entering letters into the CorPub system as letters migrate to that system.Serve as back up correspondence reviewer for other Magellan products. Also, participate in maintenance of state UR licenses, as related to correspondence.

General Job Information

Title

Sr. Correspondence Specialist

Grade

20

Job Family

General Services Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

7/29/2019

Date Requisition Created

7/29/2019

Work Experience

Healthcare, Managed Healthcare, Operations

Education

GED, High School

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

PREFERRED QUALIFICATIONSKnowledge, Skills, Abilities: Compliance background preferred with state and contractual requirements. This position prefers a solid understanding of the NIA workflows in relation to policies and standards; knowledge of lines of business: HMO, PPO, ASO, Medicaid, Medicare. Strong knowledge of legislative/oversight bodies (i.e., AAHC/URAC, CMS, NCQA, and ERISA).WORKING ENVIRONMENTThis position may include the following situations: sitting, standing, lifting up to 25lbs. and typing.MINIMUM REQUIREMENTSEducation: BA/BSField(s) of study: Business Management or Healthcare related fieldExperience: 3-5yrs.Industry: 3-5 yrs healthcare industryJob Specific: 2-3 yrs experience with managed care, utilization review.Education and/or experiences may run concurrent.Knowledge, Skills, Abilities:Ability to type 40-60 WPMOther: Excellent verbal and written communications skills; excellent organizational skills.Basic knowledge of legislative/oversight bodies (for example, AAHC/URAC, CMS, NCQA, and ERISA).Computer Skills: Possess experience and thorough understanding of word processing and other relevant software systems and applications.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.