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Position Description


Position:  Secretary, Member Response & QA - 8
Reports To: 
Division:  HA Customer Service (9900)
Location:  Label
Job Code:  60119E
Min Salary:   29800
Date Posted:  10/8/2013

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Position Specific Requirements: No position specific requirements.

Job Summary
The Member Response Secretary assists the Member Response Coordinators with the Member complaint resolution and appeal process.

Nature & Scope
This position reports to the Customer Service Manager and is responsible for secretarial duties for the Member Responses Coordinators. Duties include sending extension letters to Members, attending Second Level Appeals, taking minutes and typing them in the appropriate format and maintaining records and working appeal reports. Also, processing incoming CSW mail queue and distributing that incoming CSW mail to correspondence and appeals to the appeal department, distribution of appeals to Member Response Coordinators and sending out mail for appeals.    

Skills, Knowledge and Abilities

1. Ability to communicate effectively both orally and in writing.

2. Ability to organize work flow for maximum efficiency, and to function independently in the absence of the supervisor.

3. Ability to communicate effectively with employees on all levels, as well as third parties.

4. Ability to effectively use word processing equipment, personal computer, copiers, shredding machines, fax machines, calculators, recorders and other office equipment.

5. Demonstrated reliability in work attendance and performance, and use of appropriate discretion in maintaining confidentiality of all company information, including any sensitive proprietary or personal health information.

Minimum Job Requirements

1. High School diploma (or equivalent) courses in English composition, business math and typing.

2. Typing 45 words per minute.

3. Experience performing  secretarial functions including composition and typing of memos/letters, scheduling appointments, taking minutes, answering phones, maintaining files, etc.

4. Computer literacy, PC experience  using MS  Office  (Word, Excel, MS Outlook, etc)

5.  Above average interpersonal and communication skills.

Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

• Processes incoming mail queue and distributes inquiries to the Correspondence and Appeals queue as applicable.
• Responsible for sending and scanning FAX messages to appropriate individuals
• Distributes incoming appeals, complaints and appeal responses to the MRCs and maintains distribution log.
• Copies and routes all appeal files to the appropriate reviewer.
• Handles daily mailings and copying for appeals.
• Maintains appeal, complaint, and Arkansas Insurance Department complaint files.
• Prepares appeal files for imaging in Filenet.
• Ensures files are imaged in Filenet correctly.
• Performs periodic reviews of files to insure all complaint and appeal files are in place and all appropriate correspondence is in file.
• Attends the Second Level Appeals meetings; sets up conference phone, takes minutes and types them in the appropriate format
• Maintains manual with all Second Level Appeals minutes and makes this information available to management and for outside audit upon request.
• Sends weekly status report to the Medical Directors of outstanding cases.
• Sends extension letters as needed
• Assists with PCP member population report as needed as back up to Supervisor.
• Shares responsibility for the upkeep of the MFD machine.
• Performs other duties as assigned.
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