Job Description

Experience Requirements:

• Minimum 3 to 5 years of experience in mailroom operations or a related administrative role.
• At least 2 years of experience in a senior mailroom position.
• Experience working with US Health Plans (e.g., Medicare Advantage, Commercial, or Medicaid).
• Familiarity with Claims, Eligibility, COB, Refunds, and Provider Correspondence workflows.
• Hands-on experience with document imaging and indexing tools
• Strong understanding of mail classification, batching, scanning, indexing , and routing processes.
• Ability to monitor queue volumes, track SLAs, and report on daily/weekly mailroom performance.
• Exposure to client communication or participation in internal audits preferred.
• Experience in handling return mail, stale checks, or provider refund letters is a plus.
• Prior experience working in a Healthcare environment is strongly preferred.
• Demonstrated knowledge of healthcare privacy and security regulations (e.g., HIPAA).
• Experience handling confidential medical records , lab reports, and prescription materials.
• Experience in mentoring or training junior mailroom associates.
• Proven ability to manage complex mailroom workflows and coordinate with multiple departments.
• Good with MS Office, training and reporting.

Key Responsibilities:

Listed below are the primary job duties and responsibilities that are required:

• Receive and log incoming physical and electronic mail from members, providers, and third-party administrators.
• Sort and categorize mail based on document type (Claims, Refunds, Appeals, COB, Eligibility, etc.).
• Scan and index documents into the designated workflow systems
• Prepare, label, and process outgoing mail and packages in accordance with healthcare policies and regulatory standards, including HIPAA compliance.
• Ensure high accuracy and quality in document imaging and routing.
• Route mail to appropriate business units such as Claims Adjudication, Enrollment, Finance, or Provider Relations, Customer service team.
• Manage outgoing correspondence including member communications, refund letters, and claim return packages.
• Track and report daily mailroom volumes, turnaround times, and exceptions.
• Identify misdirected or duplicate mail and take corrective actions.
• Support audits, internal controls, and process improvement initiatives.
• Operate mailroom equipment such as postage meters, scanners, copiers, and secure shredders.
• Coordinate with courier services and internal departments to ensure timely and secure delivery of medical and administrative materials.
• Follow all healthcare privacy, safety, and security protocols when handling sensitive patient information.
• Assist with special projects and perform other duties as assigned.
• Maintain confidentiality and compliance with HIPAA and Health Plans data protection policies.

Behavior Skills:

• Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines.
• Review data for deficiencies or errors, correct any incompatibility if possible.
• Adhere to the team norms for making the overall team a cohesive one.
• Ability to prioritize and manage workload.
• Communicates clearly and concisely, with sensitivity to the needs of others.
• Participates in any required training sessions/seminars.
• Participates in special projects as requested.
• Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers, and employees.
• Establishes and maintains effective working relationships with co-workers.
• Ability to work independently, seeking supervision as needed.
• Ability to communicate professionally, clearly, and effectively, verbally and in writing.
• Ability to meet attendance requirements to effectively fulfill all functions of the position.
• Ability to independently follow through on assigned tasks, without prompting.
• Ability to prioritize effectively and multitask.

Qualifications & Skills:

• Bachelors degree or equivalent experience (preferred).
• 13 years of experience in US Healthcare Mailroom / Document Management / Claims Intake process.
• Knowledge of health plan operations (claims, eligibility, COB, refunds) preferred.
• Proficiency with document imaging tools and MS Office applications.
• Strong attention to detail, organizational, and analytical skills.
• Ability to meet SLAs, multitask, and work in a fast-paced environment.
• Good written and verbal communication skills.
• Basic understanding of HIPAA compliance.

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