Clerical Assistant Level 1 (Pleasanton, CA)

Clerical Assistant Level 1 (Pleasanton, CA)The Clerical Assistant will function as support to the Member Service Department to ensure smooth workflow and productivity. He/she will receive calls, determine nature of business, and will direct calls to destination by performing the following duties: Operates telephone console to receive incoming calls Directs caller to destination Performs a variety of clerical duties Mail distribution including receiving UPS and Fed ExAddress changes Redirects return mail Update procedures manual Responsible for composing the new hire binder May assist Operations with month end tasks Occasional moderate to heavy lifting, occasional travel to local mail house and/or local post office Reliable and predictable attendance is an essential function of this job Clerical Assistant Levels: Level I - The Member Service Representative (MSR) Clerical Assistant will function as support to the Member Service Department to ensure smooth workflow and productivity. Operates telephone console to receive incoming calls; direct caller to designated MSR's. ITL call messages if necessary. Compiles and accurately gathers information to record Member Service statistical reports on a daily, weekly monthly and yearly basis. All incoming mail is issue tracked to the appropriate MSR and copy saved on appropriate M drive/Fund specific. Process and log incoming injury detail letters by reviewing and tagging all related claims via ITL to the appropriate Claims Analyst. Assists MSR's with requests, i.e.: additional information, PT, DME, Pre-Auth. Input of medical information to system, such as Physical Therapy RX's; Durable Medical Equipment details, Pre authorizations (medical/dental) on El Dorado System with proper system documentation and other documentation that is deemed important for a Members record keeping. Prepare medical records for independent medical review. Tracking and logging of all appeals. Pick up all after hour/voicemails calls and move appropriately within the team. May be assigned special projects. Level II - Must have met the "Level I" requirements and has continued to maintain with their workload in a timely manner and consistency in accuracy of information being moved throughout the departments. Has proven ability to provide accurate information in all areas of responsibility. Has the ability to train his/her co-workers. May be assigned special projects.