Correspondence Specialist

Medicare Advantage Health Plan Miramar, Florida


Description

Position at Clear Spring Health

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Company Overview:

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina and offers Medicare Prescription Drug Plans in 42 states plus DC.

Group 1001, and its affiliated companies, is strongly committed to providing a supportive work environment where employee differences are valued. Diversity is an essential ingredient in making Group 1001 a welcoming place to work and is fundamental in building a high-performance team. Diversity embodies all the differences that make us unique individuals. All employees share the responsibility for maintaining a workplace culture of dignity, respect, understanding and appreciation of individual and group differences.

Job Summary

The Correspondence Specialist conducts procedures related to the submission of member data and review of regularly received reports from CMS.

 Main Accountabilities

  • Processing of Medicare disenrollments, cancellations, including application data entry.
  • Processing attestations received by members to avoid a Late Enrollment Penalty imposed by CMS.
  • Processes inbound correspondence received from various sources (e.g. address changes, enrollment and disenrollment cancellations), investigates returned mail, manually updates the MA billing and enrollment system, and generates outbound correspondence with limited variable language/free form text.
  • Makes outbound correspondence-related calls.
  • Gather records pertinent to specific problems, review them for completeness and accuracy, and attach records to correspondence as necessary.
  • Daily tasks include: ongoing incoming and outgoing phone calls; ongoing incoming and outgoing email; ongoing use of member database and members’ electronic medical records; processing paper mail; and processing faxes.
  • Assist management in the direction of the multi-functional activities of the department, meeting internal and contractual commitments, assuring quality of process and direction of resources.
  • May be required to work off-shift (nights, weekends, and holidays) as necessary.
  • Respond to and answer all member and provider inquiries in a courteous, responsive, and timely manner following all departmental and organizational policies and procedures.
  • Use call tracking systems to document communication with members and providers.
  • Coordinate mailing of member materials as needed.

 Qualifications:

  • Must possess exceptional oral and written communication skills, including the ability to manage difficult callers and conflict.
  • Ability to multi-task, good organizational and time management skills.
  • Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
  • Able to work cooperatively with other departments.
  • Strong communication skills, basis computer skills (verbal and written).
  • Must be able to work and act independently and be self-directed.
  • Minimum 1-2 years prior customer service experience is preferred or related experience.
  • Minimum Education: High School/GED required, Bachelor’s degree preferred.
  • An understanding of the health insurance industry is preferred.