Reporting to the Manager of the Claims & Servicing Documentation Team, the Documentation Specialist Senior authors and ensures the integrity of clear and accurate content for use by staff in the following departments: Commercial Claims, Public Plans Claims, Tufts Medicare Preferred Claims and Commercial Servicing. The Documentation Specialist Senior also, leads content creation initiatives and other information management projects, facilitates meetings relevant to documentation and communicates with partner departments as necessary to support those projects. Work will be performed in the SupportPoint, Connections, FileNet, FactLink, and FactLink Admin systems. Assists in onboarding and training writers, also trains internal clients. Work is primarily performed in an online reference tool.

The successful candidate must be extremely organized and detail oriented, must have strong writing skills that include a facility with plain language, and must possess the ability to think critically. The successful candidate must follow-through to ensure effective problem resolution. Experience with procedural and reference writing is highly preferred. SQL Database experience is preferred. Claims investigation in the TAHPA, Diamond, Monument Xpress, Health Rules Payor, and CMT systems are also preferred.

 

Job Description

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS

Creates and manages content:

• Authors clear and comprehensive documents that describe business processes and information.
• Analyzes source material and works with subject matter experts to determine how information should be structured for effective use by staff.
• Subject matter expert for the online reference tool.
• Ensures editorial standards and timeliness of documentation by regularly reviewing and updating existing content.
• Use appropriate computer applications to produce resources for use by staff.
• Ensure effective use of these applications by using advanced features of the software (style guides, etc.)
• Maintain awareness of daily events in the departments we support; create and update documentation to address service issues identified.

Ensures effective implementation of identified projects to improve department performance or to meet changing business needs:

• Investigates root causes of problems that arise and recommends appropriate course of action to resolve the problem. Assists teammates with complex issues.
• Facilitates implementation of approved solution, including (when applicable) the coordination of resources, development of detailed project plans, and the definition of key deliverables.
• Communicates with staff, along with partner departments to assess customer needs:
  Communicate regularly with appropriate department contacts to understand their needs as related to our internal clients.
• Provide support to management and team members as needed.
• Provide training refreshers to partner departments as needed.

Coordinates with internal customers (partner departments) to assess customer need:

• Communicates regularly with appropriate department contacts to understand their needs.
• Subject matter expert for the online reference tool and best practices.
• Project representation.
• Database support
• Provide support to management as needed.

 

Requirements

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

EDUCATION:

• Bachelor’s Degree or equivalent relevant work experience is required.
• Excellent verbal and written communication skills generally acquired through college or other advanced education is required.

EXPERIENCE:

• Requires two (2) years of experience in a professional environment, preferably within managed care.
• Proficiency in knowledge management and electronic data management techniques are highly preferred.
• Facility with plain language writing styles is also preferred.
• Demonstrated proficiency in the use of computers, specifically PC-based applications, is essential.
• Experience with Microsoft Office applications and Web development tools is highly preferred.

SKILL REQUIREMENTS:

• Requires the ability to assess all work and prioritize as necessary. Must be highly organized and be able to juggle multiple priorities effectively. Must be able to work independently.
• Must be able to exercise appropriate judgment as necessary. Requires excellent verbal and written communication skills to effectively impart information to others. Must be an effective and confident facilitator. Requires strong ability to research and respond to data analysis, report generation and presentation in a consistent and professional manner.
• Must be able to understand and identify critical business issues and propose recommendations for solution of those issues.
• Requires attention to detail to accomplish critical tasks, as well as a thorough understanding of the task’s impact on not only the team’s customer departments, but also on the organization as a whole.
• Requires detailed knowledge of the functions of various departments within the organization and how those departments interact.
• Requires the ability to envision the impact of change, and to be able to conceptualize and propose new ways to do business. Must have leadership abilities and be flexible and accepting of change.

 

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

 

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

Please note: As of January 18, 2022, all employees — including remote employees — must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

 

About Us

Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

At Point32Health, we’re working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.

This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: 4033

Posted On: Tuesday, June 21, 2022