Fallon Health

  • Distribution Services Representative III

    Location US-MA-Worcester
    Posted Date 2 weeks ago(11/6/2018 5:03 PM)
    Job ID
    5412
    # Positions
    1
    Category
    Distribution Services
  • Overview

    About Fallon Health

    Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.

     

    Brief summary of purpose: Assists with day to day operations of department, assuming responsibility in the absence of the Supervisor. Provides guidance and instruction and monitors the daily work for an assigned group to ensure operational business needs are meet and adherence to established policy and procedures. Works under the guidance of the supervisor and raises concerns to address resource

    Constraints, interpret policy, establish new procedures and resolve conflicts. In addition, this role will perform the work of a Distribution Services Rep II as an individual contributor.

     

     

    Responsibilities

    • Assist with Enrollment batching process.
    • Print and mail HIPPA Letters
    • Scanning items in accordance with FH guidelines – This includes prepping of documents prior to scanning (remove staples, tape, photocopy when needed)
    • 60 – Day Conversion letters
    • Data entry and filing of payment batches
    • Produce daily reports for use by department staff. 
    • Strictly observe the Fallon Health policy regarding confidentiality of member information. 
    • Sorts and delivers all inter-company mail/packages and follows up on any mail/packages not properly labeled.  
    • Miscellaneous cleanup of storage areas, mailroom, dock area etc. Able to work independently and demonstrate flexibility. 
    • Process and deliver return mail to the appropriate department for handling 
    • Stamp mail. 
    • Additional duties may be assigned or requested by the Supervisor or Director of Enrollment & Billing Operations. 
    • Maintains files and records usually of highly confidential nature. Prepares confidential and special reports as required 
    • Ensures that all certified mail is logged and gets to the Post Office on a daily basis for all departments (3:30pm) in addition to a 4:30pm pick up for HMS. Delivers mail to Post Office 1-2 times daily utilizing the FCHP van. Ensures mail is secured and delivered to the Post Office daily. Utilizes safety and confidentiality. Represents Fallon in a positive and professional manner. Has a valid driver’s license. 
    • Picks up and delivers all boxes, packages etc. and logs them and gets a signature from recipients. Ensures all boxes and packages are delivered to the correct person or department. Ability to handle a two- wheeler, mail cart and pallet jack.
    • Delivers copy paper to all departments on Mondays and logs it for inventory. Ensures 9th floor departments are kept in stock of copy paper. 
    • Daily, close and lock mail room and turn off lights to ensure security of mailroom Dept.
    • Additional duties may be assigned or requested by the Supervisor or Director of Enrollment & Billing Operations.
    • Imaging, data management, analysis and reporting
      • Ability to assist staff with the production of letters and monthly department metrics.
      • Assist with enrollment application batching
      • Assist with premium payment coding
      • Maintain Imaging folders
      • Retrieve images in Alchemy and return to the requestor the images utilizing e-mail.
      • Updating the excel spreadsheet with the daily retrieval counts.
      • Respond to e-mail / paper within the same day.
      • Place report numbers into excel sheet for scanned totals and rescanned totals.   This should be done daily and should take no more than 20 minutes.
      • Printing out member request from both QNXT and Customer Service database on Avery labels. 
      • Filling out member with correct material.  Informing predestinated Customer Service rep for items on hold. 
      • Updating binder with new material. 
      • Order material before supplies run out. 
      • Complete request same day they are received.  All labels should take no longer than 2 hours to complete. 
      • Making sure all letters are folded, postage charged back to correct department and spreadsheet is up to date.
      • Call for repairs and updating repair log when needed.
      • 100% accuracy. 
    • Sales & Customer Service Fulfillments
      • Printing out member request from both QNXT and Customer Service database on Avery labels. 
      • Filling out member with correct material.  Informing predestinated Customer Service rep for items on hold. 
      • Updating binder with new material. 
      • Order material before supplies run out. 
      • Complete request same day they are received.  All labels should take no longer than 2 hours to complete. 
      • 100% accuracy.
      • Print out sales fulfillment request from Avenue. 
      • Collate and fill orders has needed. 
      • Update reports in excel. 
      • Order supplies from Wilde as needed. 
      • E-mail sales rep and sales admin assistant if unable to fulfill orders. 
      • All orders must be filled, shipped or delivered to P2 storage same day unless summary of benefits arrive too late in the day to print. 
      • Look up benefit summaries, benefit codes and anniversary dates as needed to fill orders.
    • Participates in training and developing team
      • Participates in the orientation of new staff.
      • Assists with training and mentoring staff on the application of policy and procedures, documentation requirements, best practices, escalation requirements, use of supporting systems/applications, time management skills, etc.
      • Provides feedback to the supervisor on team members’ performance – achievement of goals and deliverables and assessment of competencies.

    Qualifications

    Education: High School diploma

     

    License: Valid Drivers License

     

    Experience:

     

    • Preferably 1 – 2 years of experience in insurance industry
    • Six months to one year general office experience required
    • Ability to lift up to 50lbs.
    • Proficiency in MS Office software with the ability to generate spreadsheets and reports

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