Correspondence Processor

Job Summary

Provides support for member correspondence activities. Responsible for generating clinical determination letters for members and providers, and following established guidelines and standards related to correspondence processing. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Assists with generating clinical determination letters to members and providers, ensuring all letters are clear, accurate, and meet the required reading grade level.
• Collaborates with internal teams to ensure correspondence meets regulatory requirements, including plain language and appropriate format.
• Assists in monitoring letter queues to ensure timely generation and delivery of all necessary correspondence.
• Responds to inquiries and assists with troubleshooting issues related to letter creation or delivery.
• Supports ongoing feedback processes to ensure letters are accurate, integrate relevant information, and maintain high-quality standards.
• Demonstrates strong attention to detail and accuracy when processing letters to meet company and regulatory standards.
• Develops a basic understanding of healthcare programs, processes, and relevant software systems and applications.
• Ensures clear and concise correspondence.
• Supports internal teams, including working with both technical and non-technical staff to ensure proper letter production.

Required Qualifications

At least 1 year of experience in an administrative support role, preferably within a health care environment supporting correspondence or clinical communications, or equivalent combination of relevant education and experience.

Previous experience as a Correspondence Processor at Molina.

Strong attention to detail, and ability to work within regulatory and internal requirements for letter generation.

Strong organizational and time-management skills, and ability to manage multiple letter queues and deadlines.

Excellent verbal and written communication skills, and ability to ensure clarity and precision in all correspondence.

Willingness to learn and adapt to new programs, software systems, and lines of business.

Ability to research, obtain feedback, and integrate necessary adjustments into letters to meet quality standards.

Ability to manage multiple tasks simultaneously, and ensure quality and compliance in all produced correspondence.

Ability to maintain confidentiality and ensure compliance with all relevant guidelines, regulations, and policies in processing of clinical correspondence.

Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet deadlines.

Ability to collaborate effectively with team members and internal departments.

Basic Microsoft Office suite / applicable software program(s) proficiency.