Supervisor, Mailroom Operation

Found in: Talent US C2 - 2 weeks ago

Long Beach, United States SCAN Health Plan Full time

Supervisor Mailroom Operations

Full-Time (Onsite Daily )

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit , , or follow us on LinkedIn, Facebook, and Twitter.

The job

Responsible for the day-to-day supervision of the department assistant staff and activities related to Medicare, Medi-Cal (Medicaid) health plan and employer group member record documents, record retention, and mail room activities.

You will

Oversees the efficiency and compliance of daily member record documents, record retention and returned mail in adherence of all Health Insurance and Accountability Act (HIPAA) laws by securing Protected Health Information (PHI) and Payment Card Information (PCI) in accordance with regulatory guidance and internal policy and procedures ensuring timely and accurate outcomes.  Monitors the work between cross-functional departments by coordinating support to Enrollment, Reconciliation, Premium Billing (ENR), Claims, Grievance and Appeals (GAD) departments. Ensures the processes are met and/or exceed regulatory requirements by understanding issued guidance from Medicare Centers of Medicare Services (CMS) and Medi-Cal Department of Health Care Services (DHCS) and internal policies and procedures including identifying and editing all internal desktop and policies and procedures in accordance of any new regulatory guidance or changes. Oversees and monitors the accuracy and timely delivery of incoming and outgoing communications by processing internal and external mail (standard or electronic) upon receipt and facilitating delivery to the appropriate recipient. Oversees the retention and disposal of member records and membership correspondence are compliant in are in accordance with federal regulation under HIPPA, PHI and PCI Financial Data by coordination of critical and sensitive member enrollment documents, member correspondence and information- including retention, storage, processing, and retrieval of records including working with offsite vendor. Improves processes by evaluating existing member record documents, record retention and return mail workflows and offering suggestions to Management on implementation or monitoring guidelines. Trains staff and monitors work to ensure operations are at the level necessary to meet established guidelines and regulatory requirements. Oversees workflow, productivity, documentation, assigns work responsibilities and tasks, and prioritizes deliverables to meet department goals and objectives. Fields escalated issues and non-routine questions, providing guidance and direction to team. Keeps abreast of changes to legislation and regulations which pertain to health insurance procedures.  Oversees the preparation of reports by collecting, analyzing, and summarizing information and trends, recommending to management a course of action. Facilitates and works with management team to fulfill audit requests as needed. Maintains staff job results by communicating job expectation, coaching, counseling, and disciplining employees; planning, monitoring, and appraising job results and contributing to a positive team atmosphere. Contributes to team effort by accomplishing related results as needed. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Your qualifications

A comparable combination of education/experience and/or training will be considered equivalent to the education listed above. Experience in Health Care Management required or 3+ years of relevant experience in the healthcare industry. Experience in healthcare (Medicare Advantage HMO) is preferred. Strong understanding of Medicare and Medicaid regulatory processes and requirements. Strong understanding of Medicare and Medicaid regulatory processes and requirements. Strong analytical skills preferred. Strong verbal and written communication skills.  Ability to communicate effectively with direct reports, management, customers, and other stakeholders. Strong customer service skills. Ability to manage multiple responsibilities with minimal supervision. Approved access to CMS MARx eligibility system is required.

What’s in it for you?

Base salary range: $52, - 84, An annual employee bonus program Robust Wellness Program Generous paid-time-off (PTO) Eleven paid holidays per year, plus 1 additional floating holiday Excellent 401(k) Retirement Saving Plan with employer match. Robust employee recognition program Tuition reimbursement A work-life balance

An opportunity to become part of a team that makes a difference to our members and our community every day

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