The posting
Job Description
Your Role
The Blue Shield Promise Medi-Cal Appeals and Grievance team researches and resolves member/subscriber grievances, appeals, and interprets and explains health plan benefits, policies, and procedures to Medi-Cal enrollees. The Clerical Support, entry position will report to the Operations Supervisor In this role you will activate and scan incoming correspondence accurately by utilizing department date/timestamp. Distribute all incoming mail accordingly to appropriate departments with no impact to compliance. Monitor department voicemail box to ensure messages are communicated timely. Provide feedback to leadership as well as ensuring PHI is not left out within all fax, printers, and open areas within the department at the end of the day.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Responsibilities
Your Work
In this role, you will:
- Process, sort, and distribute incoming mail and documents.
- Prepare, proofread, assemble, and distribute documents and materials.
- Triage incoming phone calls and inquiries and route requests appropriately.
- Maintain filing systems and records.
- Prepare and track outgoing mailings and packages.
- Check all outgoing mail to ensure no PHI is displayed through the window envelopes and make necessary adjustments as needed.
- Provide proof of mail for every letter mailed to Blue Shield Promise members.
- Manages Appeal AOR inventory-will verify in My Power if AOR is on file, calls members to follow up on AOR’s, sends day 15 and dismissal letter
- Check with management in ordering supplies for mail or supplies for management (stamps, paper etc.)
- Ensure enclosures are appropriately attached to all letters
- Support the team from Blue Shield’s Long Beach office 5 days a week
Qualifications
Your Knowledge and Experience
- High School Diploma or GED or 1 year of additional relevant experience in lieu of a diploma
- Ability to work on-site at our Long Beach office location required
- 1 year of prior clerical experience preferred
- Knowledge of Microsoft Systems such as Power Point, Excel, and Word preferred
- Ability to multi-task and meet required deadlines
About Blue Shield of California and the Ascendiun Family of Companies
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Ascendiun, we believe in a brighter future for healthcare. As the parent to a family of four innovative healthcare companies, we’re reimagining what’s possible. Ascendiun is guided by the goal of transforming a dysfunctional American health care system into one worthy of our family and friends and sustainably affordable for everyone.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, and showing empathy by understanding others’ perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
- For most teams, this means coming into the office two days per week.
- Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
- For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
