Job Description:
• Write and edit NOA letters that explain decisions about healthcare services, coverage, or benefits
• Use templates and guidelines to ensure letters are accurate and compliant with AHCCCS and other applicable regulations
• Work with internal teams (such as clinical, legal, and customer service) to gather necessary information
• Ensure letters are written in plain language and are culturally sensitive and easy to understand
• Meet strict deadlines for letter completion and delivery
• Maintain confidentiality and follow HIPAA (Health Insurance Portability and Accountability Act) and other privacy regulations
• Assist with audits and quality checks of outgoing letters
• Support the prior authorization department and Notice of Action Department by writing member letters and provider faxes
• Call on providers and members to get the needed information to complete the notifications
• Manage high volumes of member letters and/or provider faxes, averaging 3000–4000 per month
• Write medical, pharmacy, dental, and behavior health letters and ensure they are mailed out within the 24-hour, 72-hour, and 14-day regulatory timeframes
Requirements:
• 1+ year of experience working with medical terminology
• Strong written communication and grammar skills
• Ability to understand and explain complex information in simple terms
• Attention to detail and strong organizational skills
• Comfortable working with templates, forms, and computer systems
• Ability to work independently and manage time effectively
• Experience in healthcare, insurance, or customer service
• Familiarity with AHCCCS, MCA (Medicare Coverage Analysis), and Medicare
• Bilingual or multilingual skills
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access