Job Description
- Job Description:
- Write and edit NOA letters that explain decisions about healthcare services, coverage, or benefits
- Use templates and guidelines to ensure letters are accurate and compliant with AHCCCS and other applicable regulations
- Work with internal teams (such as clinical, legal, and customer service) to gather necessary information
- Ensure letters are written in plain language and are culturally sensitive and easy to understand
- Meet strict deadlines for letter completion and delivery
- Maintain confidentiality and follow HIPAA (Health Insurance Portability and Accountability Act) and other privacy regulations
- Assist with audits and quality checks of outgoing letters
- Support the prior authorization department and Notice of Action Department by writing member letters and provider faxes
- Call on providers and members to get the needed information to complete the notifications
- Manage high volumes of member letters and/or provider faxes, averaging 3000–4000 per month
- Write medical, pharmacy, dental, and behavior health letters and ensure they are mailed out within the 24-hour, 72-hour, and 14-day regulatory timeframes
- Requirements:
- 1+ year of experience working with medical terminology
- Strong written communication and grammar skills
- Ability to understand and explain complex information in simple terms
- Attention to detail and strong organizational skills
- Comfortable working with templates, forms, and computer systems
- Ability to work independently and manage time effectively
- Experience in healthcare, insurance, or customer service
- Familiarity with AHCCCS, MCA (Medicare Coverage Analysis), and Medicare
- Bilingual or multilingual skills
- Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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