Insurance Claims Coordinator jobs in Boston, MA

This role is within our Service Operations Team and it's responsibilities include accurately entering Mass General Brigham's Health Plan correspondence to member and provider records and work within various systems to report and resolve data entry issues and data discrepancies according to department guidelines.

• Training begins In-Office, but the role can be Hybrid/Remote after training
• Salary - Mid to Upper $40's/yr
• Excellent role for those with Entry Level Administrative experience looking for a more career focused position!

ESSENTIAL FUNCTIONS

• Responsible for reviewing and sorting all incoming correspondence for all departments, including but not limited to Claims, Grievance/Appeals, COB/TPL, and Member Reimbursement.
• Responsible for understanding the distinction between correspondence of business within the Mass General Brigham Health Plan to ensure proper and effective interpretation of data.
• Handle complex and non-complex claim correspondence and strive to deliver best practice.
• Demonstrate strong interpersonal skills, high level of initiative, excellent written and verbal communication.
• Exceptional awareness of HIPAA regulations to ensure all member PHI is protected while handling correspondence.
• Responsible for reviewing all documentation, logging, forwarding, and transmitting correspondence for scanning and/or storage within agreed upon service level agreements.
• Analyze and interpret data as it relates to logging of correspondence and trends.
• Able to prioritize work tasks with the day to day business from other departments, including but not limited to Provider Relations, Compliance, Claims, COB/TPL and Provider Appeals.
• Oversee the daily assignments of temporary employee and interns as directed by management.
• Responsible for meeting all department quality and productivity performance standards.
• Responsible for following all recommended processes and implementing approved process changes effectively to ensure efficiency and productivity levels.
• Responsible for identifying and resolving document/imagery discrepancies by utilizing daily reports provided by New England Documents.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements.
• Establish and maintain effective and collaborative relationships with customers..

WORKING CONDITIONS AND PHYSICAL EFFORT

• Work is performed in a typical office work environment.

MINIMUM REQUIREMENTS

KNOWLEDGE AND EDUCATION

Required:

• Associates Degree or equivalent combination of training and experience, plus 1-2 years of related experience.
• Knowledge of Word, Excel and Outlook, Adobe

Preferred/Desired:

• QNXT or similar systems experience

EXPERIENCE

Required:

• 1-2 years data entry experience.
• Excellent written, verbal and communication skills including proficient use of English.

Preferred/Desired:

• 2 years of related experience
• Knowledge of enrollment and Insurance claims logging
• Knowledge of internal correspondence logging process

SKILLS/COMPETENCIES

• Knowledge of claim forms (professional and facility)
• Attention to detail, decision making, problem solving, time management and organizational skills, communication, and teamwork
• Must be able to multi-task and be prepared for quick changes to daily tasks.
• Demonstrated competency in high-productivity data entry environment
• Good follow-up skills, seeing tasks to completion
• Accountable for delivering high quality work
• Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner.
• Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.
• Verse in Audit skills with attention to detail.

Works with minimal supervision; ensures daily service level agreements are met using available processes and resources.

This position interacts within the Mass General Brigham Health Plan with team members in various departments, including staff and management level personnel. Outside the Mass General Brigham Health Plan, this position is responsible for day-to-day interactions with vendor representatives.

Job Type: Full-time

Pay: $42,000.00 - $49,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Evening shift
• Monday to Friday
• Weekends as needed

Experience:

• Administrative: 1 year (Required)

Work Location: Hybrid remote in Somerville, MA 02145