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Clerk III, Claims Sort/Mailroom (2:55 PM - 11:30 PM)


Job Summary

This role provides clerical services in opening, identifying, prepping and sorting all incoming mail/documents for all lines of business and contracts in order to bring them under initial control within a strict timeframe.

Characteristics and Responsibilities
  • Perform various clerical tasks requiring some diversity and application of several established procedures.
  • Pull rejected claims as indicated on Reject Reports by locating appropriate batches and searching for identified claim numbers.
  • Perform final check to ensure all rejected claims have been removed utilizing computer application and visual verification that identified claims are not included in batches.
  • Open, identify, sort and route non-claim documents to the appropriate departments.
  • Open, identify, sort and distribute all incoming mail based on division and department.
  • Identify, sort and prep all claims according to document type, scanning needs and guidelines for multiple contracts.
  • Identify and prep claims for OCR scanning according to established guidelines.
  • Identify and prep specified internal and external departmental non-claim documents in proper order according to established guidelines.
  • Use computer to obtain additional claim/document information as needed.
  • Use computer to navigate/search the training manual for procedures.
  • Use computer to address and send system-customized letters to beneficiaries and providers as required.
  • Identify and return claims/documents to providers/beneficiaries or other contractors for resubmission as needed.
  • Provide a variety of daily statistics for inventory reporting purposes.
  • Perform basic, routine equipment maintenance, including, but not limited to the automated mail opening equipment.
  • Meet department requirements for quality based on weekly audits and quantity performance against reasonable expectancy (RE).
  • Anticipate, participate and make recommendations in changing conditions.
  • Adhere to all safety guidelines.
  • Sort and file daily and weekly productions sheets, as needed.
  • Batch and dispatch claims/documents according to specified divisional guidelines.
  • Empty recycle bins into locked containers.
  • Deliver buckets of sorted/prepped claims/documents utilizing carts as needed.
  • Maintain an organized workspace while keeping supplies stocked.
  • Comply with System security requirements contained in the WPS Information Systems Policy which include the appropriate use of hardware and software and ensuring confidentiality of assigned password(s).
  • Comply with all WPS policies and procedures, which include maintaining confidentiality of information.
  • Perform other duties as assigned.


Work Experience


  • Experience using personal computer with basic keyboarding skill.


  • High school diploma or equivalent

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