FEP Clerk I or II, DOE
Cambia Health Solutions

Job Info

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FEP Clerk I or II, DOE

Tele-Flex in WA, ID, OR, and UT

Primary Job Purpose:

The FEP Clerk performs clerical support for departments within FEP. The clerk works closely with department staff as well as staff in other corporate departments.

Normally to be proficient in the competencies listed below:

FEP Clerk would have a High School diploma or GED, and a combination of education and work experience.

Responsibilities:

• Receives, analyzes, and determines appropriate action needed for all incoming claims, correspondence and/or inquiries coming into unit.
  
• Pre-screen claims for line of business and/or type of claim. Log incoming customer service inquiries and distribute phone reports as directed.
  
• Provides administrative support such as scheduling conference rooms, maintaining supplies, delivering documents and scheduling office equipment maintenance as needed.
  
• Enter tracking information on Salesforce.
  
• Verify that information produced on ID cards and/or other documents is accurate.
  
• Distributes contracts, riders and amendments in a timely and accurate manner. Mails out individual policies and certificates. Maintains inventory of contracts, riders and amendments to ensure adequate supply is always available.
  
• Prepares on a daily basis correspondence, envelopes, applications and other records for imaging.
  
• Provides back up coverage for imaging department.
  
• Maintains and updates subscriber and/or provider files and researches returned mail for correct addresses.
  
• Retrieves claims from files; copies and distributes as directed. Tracks and prepares spreadsheets to distribute paper claims within required timeliness guidelines.
  
• Assist other staff by calling members, group administrators, agents/brokers, attorneys or providers, or other member representatives to obtain missing information and correct any errors. Assist other staff by calling provider offices to obtain clarification on billing.
  
• Assists and supports staff in sending out standard memos and correspondence. Types and sends letters to members and providers.
  
• May research and report findings back to Supervisor or Lead as needed.
  
• Willing to work overtime and on weekends as needed.
  
• Provides administrative support to all department staff.
  
• Adheres to department standards for quality, timeliness, and department processes and procedures.
  
• Able to perform all the duties of a FEP Clerk I.
  
• Supports unit by updating addresses. Returns documents, which cannot be identified, to the subscriber or provider requesting additional information or providing an explanation for non-payment. Documents any returned mail.
  
• Collect performance data and prepare monthly statistical reports as requested. Follow up with appropriate staff to collect any missing data needed to compete reports in a timely manner.
  
• Completes daily preparation of routine correspondence, applications and/or cash records. May enter incoming applications, correspondence and cash payments on the system.
  
• Selects and mails appropriate contracts, applications, provider booklets, explanation of benefits and checks with corresponding labels and ID cards for newly established members and marketing executives upon request.
  
• Responds to inquiries such as checking on the status of claims processing and advanced benefit determination requests..
  
• Maintains and archives files for department's documentation.
  
• Trains new employees on clerical functions.
  
• Communicates with other departments as necessary to deliver or collect information critical to claims processing.
  
• Provide support to Clerk I and secondary research for complex documents.
  
• Completes special projects and reports as assigned.
  
• Provides swat support to Customer Service by taking phone calls, writing and processing correspondence.
  

Minimum Requirements:

• Basic knowledge of FEP specific systems such as CRM Salesforce and Carefirst Bridge, preferred.
  
• Ability to adapt to a fast-paced, team environment.
  
• Solid administrative skills including 30 wpm keying ability, with 95% accuracy; 10-key ability.
  
• Strong communication skills on the phone, verbally, and in writing.
  
• Ability to follow instructions.
  
• Ability to handle multiple tasks simultaneously and appropriately prioritize workload with a focus on accuracy and attention to detail.
  
• Ability to learn and retain new or evolving information and procedures.
  
• Ability to work under stress and pressure and respond to inquiries with tact, diplomacy and patience.
  
• Ability to research and utilize available internal resources.
  
• Basic knowledge of Microsoft Office products such as Word and Excel.
  
• Ability to analyze incoming work to determine appropriate course of action.
  
• Strong organization, data entry and administrative skills.
  
• Demonstrated initiative in bringing forward ideas and suggestions to improve processes and documentation.
  
• Intermediate knowledge of Microsoft Office products such as Word and Excel.
  
• Demonstrated ability to work independently with minimal support from team members.
  
• Demonstrated ability to consistently meet timeliness and quality standards with minimal support.
  
• Ability to accurately identify and assign pre-authorization, appeal, privacy, and general correspondence with minimal questions.
  

Work Environment:

• Work primarily performed in an office environment.
  
• May be required to work overtime & outside normal hours.
  

The base pay annual salary range for this job is $16.20 - $24.15/hour,depending on candidate's geographic location and experience.

The annual incentive payment target for this position is 5%.

At Regence, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we do not hire candidates at or near the top of the salary range.

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights include:

• Medical, dental, and vision coverage for employees and their eligible family members
  
• Annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• Paid time off and company holidays
  
• Up to a 6% company match on employee 401k contributions (no vesting period)
  
• Up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• One-time furniture and equipment allowance for employees working from home
  
• Up to $225 in Amazon gift cards for participating in various well-being activities
  

For a complete list see our External Total Rewards at https://www.cambiahealth.com/careers/total-rewards

At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we rarely hire candidates at or near the top of the salary range.

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off and company holidays
  
• up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
  
• up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities for a complete list see our External Total Rewards page.
  

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

This job has expired.