At Shire, we are proud and grateful to employ military veterans and thank them for their contributions to our company and our country. See where your military experience can play a role at Shire by using our military skills translator job search tool below:
Why This Role is Important to Us:
The Mail House Specialist documents and conducts procedures related to mail house functions, including the data submission and compliance monitoring of Commonwealth Care Alliance (CCA) mail house vendors to identify and resolve data discrepancies.
What You'll Be Doing:
Coordinate file transactions to and from mail house vendors as needed.
Operationalize new fulfillment vendor implementation requirements.
Monitor and enforce adherence to all corporate policies and governmental regulatory compliance, as directed by company policy and procedure.
Analyze procedures and recommend/implement changes to improve performance, to maximize efficiency opportunities.
Collaborate with other departments, senior management, and compliance to ensure version controls.
Collect, develop, and analyze data regarding increases associated with membership growth.
Provide data and reports to manager on fulfillment operations and accomplishments
Investigate mailing data discrepancies, using various internal and external systems to identify the correct information and resolve discrepancies.
Meticulously and accurately execute all reconciliation activities, with a high level of quality and proactively identifying inaccuracies in data of all types.
Coordinate return mail reconciliation and work with identified staff to resolve discrepancies, to identify trends and escalate as needed
Research and respond to information requests from CCA contracted vendors.
Perform other duties as assigned.
What We're Looking For:
Preferred: Associate's Degree with 5+ years of experience.
Experience working with Medicaid & Medicare eligibility requirements and enrollment related regulations and processes preferred.
Competence to work independently; to prioritize and manage multiple activities and to meet strict deadlines.
Demonstrated ability to coordinate work with team members and third parties.
Analytical and problem solving skills.
Strong verbal, written and listening communication skills.
Proficiency in Microsoft Word
Standard office equipment. and Excel, database skills a plus.
English.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.