Assists appeals staff with proofreading appeals documents to insure accuracy. Communicates with appeals staff, enrollees and health insurance organizations. Also performs the following diversified clerical duties.

1. Performs readability and quality assurance reviews of decision letters authored by Part D Appeals staff and makes the necessary clerical corrections.
2. Provides assistance with decision notification to all appropriate parties.
3. Accurately updates the Medicare Appeal System (MAS), to reflect that the case has been completed and attaches the decision letter.
4. Assist team members in maintaining and collecting of sensitive case documents and maintenance of the case file.
5. Possibility of occasional or rotating weekend coverage.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience

Associate Degree or higher preferred with Medicare and/or health care background preferred.

 Language Ability

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Word; Microsoft Excel; Microsoft Explorer; Microsoft Outlook.

Physical Demands

While performing the duties of this job, the employee is regularly required to sit; use hands; reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and climb or balance.  The employee must occasionally lift and/or move up to 25 pounds. The employee must occasionally lift and/or move up 25 pounds.

• Apply for this job online
• Email a friend this opportunity