For over 30 years, AllWays Health Partners has delivered value to our members and worked to improve access to care and coverage. As a member of Mass General Brigham, AllWays is a health plan at the forefront of innovation, advancing a highly integrated model of value-based care with one of the world's leading health care systems. Together, we are transforming the customer experience, keeping our members and patients at the center of everything we do. Bring your unique talents and join us as we strive to create a world where all people live healthier lives.

As part of the Service Operations Team, responsibilities include accurately entering AllWays Health Partners correspondence to member and provider records and work within various systems to report and resolve data entry issues and data discrepancies according to department guidelines.

ESSENTIAL FUNCTIONS
* Responsible for reviewing and sorting all incoming correspondence for all departments, including but not limited to Claims, Grievance/Appeals, COB/TPL, and Member Reimbursement.
* Responsible for understanding the distinction between correspondence of business within AllWays Health Partners to ensure proper and effective interpretation of data.
* Handle complex and non-complex claim correspondence and strive to deliver best practice.
* Demonstrate strong interpersonal skills, high level of initiative, excellent written and verbal communication.
* Exceptional awareness of HIPAA regulations to ensure all member PHI is protected while handling correspondence.
* Responsible for reviewing all documentation, logging, forwarding, and transmitting correspondence for scanning and/or storage within agreed upon service level agreements.
* Analyze and interpret data as it relates to logging of correspondence and trends.
* Able to prioritize work tasks with the day to day business from other departments, including but not limited to Provider Relations, Compliance, Claims, COB/TPL and Provider Appeals.
* Oversee the daily assignments of temporary employee and interns as directed by management.
* Responsible for meeting all department quality and productivity performance standards.
* Responsible for following all recommended processes and implementing approved process changes effectively to ensure efficiency and productivity levels.
* Responsible for identifying and resolving document/imagery discrepancies by utilizing daily reports provided by New England Documents.
* Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements.
* Establish and maintain effective and collaborative relationships with customers..

WORKING CONDITIONS AND PHYSICAL EFFORT
* Work is performed in a typical office work environment.

MINIMUM REQUIREMENTS

KNOWLEDGE AND EDUCATION

Required:
* Associates Degree or equivalent combination of training and experience, plus 1-2 years of related experience.
* Knowledge of Word, Excel and Outlook, Adobe

Preferred/Desired:
* QNXT or similar systems experience

EXPERIENCE

Required:
* 1-2 years data entry experience.
* Excellent written, verbal and communication skills including proficient use of English.

Preferred/Desired:
* 2+ years of related experience
* Knowledge of enrollment and Insurance claims logging

* Knowledge of internal correspondence logging process

SKILLS/COMPETENCIES

* Knowledge of claim forms (professional and facility)
* Attention to detail, decision making, problem solving, time management and organizational skills, communication, and teamwork
* Must be able to multi-task and be prepared for quick changes to daily tasks.
* Demonstrated competency in high-productivity data entry environment
* Good follow-up skills, seeing tasks to completion
* Accountable for delivering high quality work
* Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner.
* Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
* Verse in Audit skills with attention to detail.

Works with minimal supervision; ensures daily service level agreements are met using available processes and resources.

This position interacts within AllWays Health Partners with team members in various departments, including staff and management level personnel. Outside AllWays Health Partners , this position is responsible for day-to-day interactions with vendor representatives.

Our promise as a people-first organization starts with our employees. AllWays Health Partners is committed to diversity, equity, and inclusion in our workforce, internal culture, and investments. As an equal opportunity employer, AllWays Health Partners recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.

Disclaimer
The above statements are intended to describe the general nature and complexity of the work being performed by personnel assigned to this classification and do not represent an exhaustive list of all tasks, duties, and responsibilities required of personnel assigned to this position.