Job Description
Experience Requirements:
- Minimum 3 to 5 years of experience in mailroom operations or a related administrative role.
- At least 2 years of experience in a senior mailroom position.
- Experience working with US Health Plans (e.g., Medicare Advantage, Commercial, or Medicaid).
- Familiarity with Claims, Eligibility, COB, Refunds, and Provider Correspondence workflows.
- Hands-on experience with document imaging and indexing tools
- Strong understanding of mail classification, batching, scanning, indexing , and routing processes.
- Ability to monitor queue volumes, track SLAs, and report on daily/weekly mailroom performance.
- Exposure to client communication or participation in internal audits preferred.
- Experience in handling return mail, stale checks, or provider refund letters is a plus.
- Prior experience working in a Healthcare environment is strongly preferred.
- Demonstrated knowledge of healthcare privacy and security regulations (e.g., HIPAA).
- Experience handling confidential medical records , lab reports, and prescription materials.
- Experience in mentoring or training junior mailroom associates.
- Proven ability to manage complex mailroom workflows and coordinate with multiple departments.
- Good with MS Office, training and reporting.
Key Responsibilities:
Listed below are the primary job duties and responsibilities that are required:
- Receive and log incoming physical and electronic mail from members, providers, and third-party administrators.
- Sort and categorize mail based on document type (Claims, Refunds, Appeals, COB, Eligibility, etc.).
- Scan and index documents into the designated workflow systems
- Prepare, label, and process outgoing mail and packages in accordance with healthcare policies and regulatory standards, including HIPAA compliance.
- Ensure high accuracy and quality in document imaging and routing.
- Route mail to appropriate business units such as Claims Adjudication, Enrollment, Finance, or Provider Relations, Customer service team.
- Manage outgoing correspondence including member communications, refund letters, and claim return packages.
- Track and report daily mailroom volumes, turnaround times, and exceptions.
- Identify misdirected or duplicate mail and take corrective actions.
- Support audits, internal controls, and process improvement initiatives.
- Operate mailroom equipment such as postage meters, scanners, copiers, and secure shredders.
- Coordinate with courier services and internal departments to ensure timely and secure delivery of medical and administrative materials.
- Follow all healthcare privacy, safety, and security protocols when handling sensitive patient information.
- Assist with special projects and perform other duties as assigned.
- Maintain confidentiality and compliance with HIPAA and Health Plan’s data protection policies.
Behavior Skills:
- Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines.
- Review data for deficiencies or errors, correct any incompatibility if possible.
- Adhere to the team norms for making the overall team a cohesive one.
- Ability to prioritize and manage workload.
- Communicates clearly and concisely, with sensitivity to the needs of others.
- Participates in any required training sessions/seminars.
- Participates in special projects as requested.
- Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers, and employees.
- Establishes and maintains effective working relationships with co-workers.
- Ability to work independently, seeking supervision as needed.
- Ability to communicate professionally, clearly, and effectively, verbally and in writing.
- Ability to meet attendance requirements to effectively fulfill all functions of the position.
- Ability to independently follow through on assigned tasks, without prompting.
- Ability to prioritize effectively and multitask.
Qualifications & Skills:
- Bachelor’s degree or equivalent experience (preferred).
- 1–3 years of experience in US Healthcare Mailroom / Document Management / Claims Intake process.
- Knowledge of health plan operations (claims, eligibility, COB, refunds) preferred.
- Proficiency with document imaging tools and MS Office applications.
- Strong attention to detail, organizational, and analytical skills.
- Ability to meet SLAs, multitask, and work in a fast-paced environment.
- Good written and verbal communication skills.
- Basic understanding of HIPAA compliance.
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