Senior Correspondence Specialist - Sacramento, CA

Sacramento, CA

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.

 Communicates directly with clients and internal departments regarding correspondence needs and letter requirements. • Interacts with compliance regarding accreditation requirements for the member and provider letters. • Consults with Magellan legal counsel for review of state and federal communication requirements. • Develop and customize letter objects and configure the appropriate enclosure conditions to meet original requirements of the project. • Ensuring Branding, Formatting and other document attributes are consistent with requirements. • Work in conjunction with internal departments to develop new letter functionality as needed to meet internal or external letter requirements. • Troubleshoot, research and respond to inquiries regarding letter issues. • Partner with IT on the development of letters to ensure accurate production results, including QA testing. • Monitor the Letter Failure report and ensure timeliness and accuracy of letters. • Assist in tracking Letter quality issues. • Develop and maintain documented quality standards. • Participates in Client and Regulatory audits.
 

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General Job Information

Title

Senior Correspondence Specialist - Sacramento, CA

Grade

20

Job Family

General Services Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

11/6/2019

Date Requisition Created

11/6/2019

Work Experience

Healthcare, Managed Healthcare, Operations

Education

GED, High School

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

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.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.

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.