Correspondence Processor

JOB DESCRIPTION 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, int...