Claims Processor II in Woburn, MA at Beacon Health Options

Date Posted: 4/27/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic Claims Processor II I to join our team in Woburn, MA! The Claims Processor II is responsible for the handling of all emails sent to the Claims Department special email boxes. Such as faxes, check requests and plan specific email boxes. The Claims Specialist, Level II is also responsible for assisting in special claim reprocessing requests, audits and Flex Care claims management folders.

Position Responsibilities:

  • Process claims for all lines of business daily meeting established production standards

  • Review and audit each batch of claims entered to identify entry errors prior to processing the claims.

  • Ensures claims are entered accurately and timely.

  • Monthly review of individual statistics to ensure accuracy rate is being met.

  • Process emails to completion that are sent to the various Claims email boxes, such as faxes. And distribute accordingly.

  • Monitor, review and release of all claims batches  in the Claims Management module in FlexCare. Includes: New, Queue, Pending and plan specific folders.

  • Review and process specialty batches

  • Ensures all applicable batches are released in time for weekly check runs.

  • Working knowledge of vendor relationships (3M and other vendors as contracted)

  • Train new claim entry staff and quality assurance (QA) of their work. Provide feedback as needed.

  • Assist when needed with the internal mail processes which includes batching and scanning of paper clams and attachments.

  • Assist in audit pulls

  • Other office duties as assigned

Position Requirements:

  • Education: High School Diploma or GED equivalent required

  • Relevant Work Experience: 2 years of data entry/processing experience required

  • Knowledge, Skills, & Abilities: Attention to detail and organizational skills required

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled