CLAIMS PROCESSOR II at Beacon Health Options
Posted in Health Care 15 days ago.
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Location: Woburn, MassachusettsJob Description:
The Claims Specialist II ensures timely and accurate processing of all claim types.
ABOUT THE POSITION
We are currently seeking a dynamic Claims Specialist II to join our team at our office in Woburn. The Claims Specialist II ensures timely and accurate processing of all claim types. The Claims Specialist, Level II is also responsible for assisting in claim reprocessing requests, and FlexCare360 claims management folders.
- Utilizing 3 rd party software to apply manual pricing to claims.
- Reviewing and correcting errors preventing claims from processing correctly.
- Work to completion internal requests via the SharePoint ticketing system, e-mail, or the designated claims request inbox.
- Enter, Review, price, and process specialty claims batches such as member reimbursements and adjustment/void batches.
- Liaison with other departments to find the correct solution to claim issues
- Monitor, review and release in accordance with prompt pay guidelines and check runs, claims batches in the Claims Management module in FlexCare. Includes: New, Queue, Pending and plan specific folders.
- Working knowledge of vendor relationships (3M and other vendors as contracted)
- Train new staff as needed
- Other office duties as assigned
Education: Bachelor's Degree in Business, Healthcare Administration or related fields; or an equivalent combination of education, training and experience is required; a minimum of five years of related work experience
Relevant Work Experience: A minimum of five years of related work experience
Knowledge, Skills & Abilities:
Proficient in MS Excel.
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
AAP Reporting Location:
MA - Woburn
ID (Req #):