Highlights

The Blue Shield Promise Medi-Cal Appeals and Grievance team researches and resolves member/subscriber grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal enrollees. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Numbers & Facts

LocationLong Beach, CA
IndustryInsurance
Company Size2,000 to 2,499 employees
Websitehttps://www.bcbs.com/about-us/careers

Description

Your Role

The Blue Shield Promise Medi-Cal Appeals and Grievance team researches and resolves member/subscriber grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal enrollees. The Clerical Support, entry position will report to the Operations Supervisor In this role you will activate and scan incoming correspondence accurately by utilizing department date/timestamp. Distribute all incoming mail accordingly to appropriate departments with no impact to compliance. Monitor department voicemail box to ensure messages are communicated timely. Provide feedback to leadership as well as ensuring PHI is not left out within all fax, printers, and open areas within the department at the end of the day.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

  • High School Diploma or GED or 1 year of additional relevant experience in lieu of a diploma

  • Ability to work on-site at our Long Beach office location required

  • 1 year of prior clerical experience preferred

  • Knowledge of Microsoft Systems such as Power Point, Excel, and Word preferred

  • Ability to multi-task and meet required deadlines

Your Work

In this role, you will:

  • Process, sort, and distribute incoming mail and documents.

  • Prepare, proofread, assemble, and distribute documents and materials.

  • Triage incoming phone calls and inquiries and route requests appropriately.

  • Maintain filing systems and records.

  • Prepare and track outgoing mailings and packages.

  • Check all outgoing mail to ensure no PHI is displayed through the window envelopes and make necessary adjustments as needed.

  • Provide proof of mail for every letter mailed to Blue Shield Promise members.

  • Manages Appeal AOR inventory-will verify in My Power if AOR is on file, calls members to follow up on AOR's, sends day 15 and dismissal letter

  • Check with management in ordering supplies for mail or supplies for management (stamps, paper etc.)

  • Ensure enclosures are appropriately attached to all letters

  • Support the team from Blue Shield's Long Beach office 5 days a week

Your Work

In this role, you will:

  • Process, sort, and distribute incoming mail and documents.

  • Prepare, proofread, assemble, and distribute documents and materials.

  • Triage incoming phone calls and inquiries and route requests appropriately.

  • Maintain filing systems and records.

  • Prepare and track outgoing mailings and packages.

  • Check all outgoing mail to ensure no PHI is displayed through the window envelopes and make necessary adjustments as needed.

  • Provide proof of mail for every letter mailed to Blue Shield Promise members.

  • Manages Appeal AOR inventory-will verify in My Power if AOR is on file, calls members to follow up on AOR's, sends day 15 and dismissal letter

  • Check with management in ordering supplies for mail or supplies for management (stamps, paper etc.)

  • Ensure enclosures are appropriately attached to all letters

  • Support the team from Blue Shield's Long Beach office 5 days a week

About Company

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

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