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Correspondence Representative II

Open 19d

Summary

Process insurance enrollment materials for CaliforniaChoice by reviewing forms, calling clients to gather missing data, and sending written correspondence while adhering to PHI guidelines.

Purpose of Position:

Send written correspondence and communicate with clients via phone to obtain, review and process enrollment materials for participants of CaliforniaChoice.

Essential Functions:

Expert knowledge of all MPC Enrollment Rep I duties. Demonstrate knowledge of Correspondence duties as determined by department assessment as well as the following:

  • Understand company policies and procedures as they apply to CaliforniaChoice plans.
  • Responsible for the review and processing of the following forms including but not limited to:
    • Employee Applications
    • Change Request Forms
    • Employee Termination Forms
    • Web Based Forms
  • Identify and obtain missing/incomplete information on forms based on guidelines and standard operating procedures.
  • Follow the department Pending Item process
  • Compose clear and concise written correspondence (i.e. pending item requests, denials, confirmations, memos, letters, etc.).
  • Place outbound calls to obtain missing/incomplete information on forms.
  • Maintain working knowledge of all products and systems used for job function (i.e. Pegasus, doc-link, SharePoint, etc.)
  • Enter appropriate comments in a clear and succinct manner into Pegasus and/or Doc-Link.
  • Meet department standards for quality and quantity of work.
  • Maintain department and team standards for turnaround times.
  • Adhere to all PHI (Personal Health Information) guidelines
  • Assist with departmental training needs as needed
  • Onsite or remote regular attendance and punctuality are essential functions of the job.
  • Performs other business tasks or functions as assigned.

See also

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