Service Center Clerk

POSITION SUMMARY

Under the direction and supervision of the Group Service Center Manager, performs duties related to mail distribution, hard copy claim preparation, print and support services for internal departments and operates mailroom and printer equipment specific for Service Center duties. Assures timely processing of company incoming and outgoing mail. Troubleshoots, researches and resolves issues related to mailroom equipment operation, timely distribution of mail, and printing and support services by maintaining effective working relations with internal and external customers and vendors. Assists the Group Service Center Manager in meeting departmental and company goals and objectives.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Key Responsibilities

• Prepares and applies Dental Claims' criteria for sorting daily incoming hard copy claims. Starts the tracking of claims inventory by stamping date control and batch number to each claim prior to forwarding to Dental Claims for imaging and data entry.

• Prepares and begins the printing function of the Explanation of Benefits (EOB) by processing the job through certified applications, generating the statements, reports and tray labels required to present to the mail courier vendor US Postal Service.

• Receives, reviews, and applies the mailroom criteria for sorting daily incoming mail for distribution to various departments, including dental claim forms submitted for payment of services.

• Retrieves daily outgoing mail from departments and assures timely mail out of outgoing pieces; allocates postage for pieces to the appropriate postage tracking account.

• Prepares and begins the printing functions of multiple job types within the Service Center by processing the jobs through their various applications and generating statements and reports for reconciliation. Prepares print jobs for mailing according to US Postal Service standards. The various types of applications include, but are not limited to:

• Explanation of Benefits

• Subscriber ID Cards

• PreAuthorization's

• QuickBites

• 1099 Financial Statements

• HDS Individual Dental Plan - Welcome and Renewal Packets

• Non-Par Dentist Letters

• Bills and Invoices for employer groups

• Procedure Code Guidelines (PCG)

• Provider/Member checks

• Contract Renewals

• Medicaid mailouts

• Notice of Privacy Practice

• Customer letters and other notifications

• Executive letters/packets

• Notice of Denial letters

• Periodic notices to participating dentists

• Process mail returns for commercial, Medicare and Medicaid business:

• update members address for mail returns

• update the dental TPA 1179 file for Medicaid return mail with forwarding address

• Operates and maintains the Feeder/Folder/Inserter machine capabilities including the JetVision back-end camera and imaging functions, to include file management and retrieval processes.

• Receives special printing and/or mail out work request orders from internal departments. Collaborates with the requesting department to assure that the work request order is met in accordance with the processing requirements, deadlines and details that are provided by the requestor.

• Monitors and maintains proper level of printing and mail supplies for the print room including paper, toner, envelopes, and postage. Delivers paper supply to departments within the company.

• Provides clerical support services as requested for other departments, including preparation of eligibility enrollment documents to be imaged, filing of documentation identified for various departments, preparation of large mail outs for other departments as needed, etc.

• Logs, maintains, and reconciles postage balances for the various accounts and initiates the request for additional funds as needed. Records and tracks number of outgoing mail pieces by account/categories.

• Monitors and maintains proper level of mailing supplies for bulk mailing including postage, envelopes, trays and other mailing supplies for Explanation of Benefits, Remittance Advices, Monthly Newsletters, ID cards, etc.

• Applies the departmental policy and procedures regarding safety controls in preventing injury when lifting, pushing, and pulling of mail cart and/or using the mailroom equipment, including the postage meter machine, date stamper, electronic mail opener, folding machine, electronic stapler.

Other Duties and Responsibilities

• Performs special projects or other related duties as required or assigned by the Group Service Center Manager.

• Identifies opportunities to increase operational effectiveness and efficiency of the department and increase value of HDS products.

• Completes routine administrative tasks to include monthly inventory control. Provides administrative support (filing, imaging, etc.) for the department.

• Other miscellaneous duties and responsibilities as assigned.

MINIMUM QUALIFICATIONS AND EXPERIENCE

Education

High school diploma or equivalent.

Experience

• At least one year of clerical experience or any combination of education and experience which would provide the necessary knowledge, skills and abilities to meet the minimum qualifications to perform the essential functions of this position.

• Computer experience preferred.

Skills and Knowledge

• Working knowledge of PC applications (i.e. word processing and spreadsheets) highly desirable.

• Ability to maintain focus and attention to detail.

• Ability to handle multiple tasks with distractions.

• Ability to troubleshoot when numbers don't balance.

• Ability to communicate orally and in writing with all levels of staff, customers, and vendors.

• Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI).

Note: The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.