Coordinator, Mailroom
SEE how you can make a difference! Be part of an innovative company that cares about its associates and helps members enjoy the wonders of sight through healthy eyes and vision.
Versant Health provides vision care to 37 million members nationwide! To ensure your continued success we provide opportunities for advancement and development. Our associates remain engaged through a comprehensive compensation and benefits package which includes health and dental insurance, tuition reimbursements, 401(k) with company match, pet insurance and FREE vision insurance for you and your family.
Scope and Purpose of Position
The Claims Clerk is a key participant in the success of the Claims department’s ability to meet our timeliness standards and performance guarantees. The Clerk’s role is to handle all of the paper claims that are received by the organization and to load them into our claims processing system. This involves opening all of the paper claims received, sorting it into pre-defined categories, prepping the mail to be scanned, and scanning the claims using our Scanner/OCR system. Responsibilities will also include verification and key data entry of fields that need additional attention. The goal of the Claims Clerk is to handle the majority of these tasks so the Claims Examiners can focus on processing claims to completion.
Essential Functions
- Manage the incoming paper claims
- Receive and open incoming Claims mail
- Sort claims into predefined sort types
- Prep claims and batch into predefined batch amounts
- Continue until all claims related mail has been opened, sorted and prepped
- Keep all mail separated by Received Date
- Scan the claims
- Turn on the Kodak scanning machine
- Feed the claims batch through the scanner
- Validate batch has been completed and accepted
- Move on to scan the next batch
- Continue until all claims related mail has been scanned
- Verify claims data
- Log in to the claims processing system
- Look at data that needs additional verification
- Make determination of the correct data for the identified field
- Move claims to the Claims Examiner for processing
- Keep track of items handled and meet quality and productivity expectations
- Communicate with Claims leadership to on how much work has been completed and how much remains to be worked
- Identify steps to improve the process
- Adhere to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)
Education & Experience
- High school graduate or equivalent is mandatory. Business related college courses preferred.
- Two years of experience in an office or production type environment where quality and production are measured. Experience with a Panasonic scanner or other similar office equipment is desirable.
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program
We take pride in our recruiting process and follow a merit-based employee recruitment practice with extensive screening steps. We will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, age, sex (including pregnancy), sexual orientation, gender identity or expression (including transgender status), national origin, ancestry, status as a protected veteran or disabled veteran, physical or mental disability or history of disability, genetic information, marital status, or any and all other categories protected by under applicable Federal, state or local law.
This policy extends to all associates and to all aspects of the employment relationship. Any associate who violates this policy will be subject to disciplinary action up to and including termination
