Insurance Claims Processor I - Primarily Remote

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High school diploma or equivalent is required., At least two years of experience in processing claims., Preferred qualifications include an associate’s degree, insurance experience, and administrative assistant experience..

Key responsibilities:

  • Handle sensitive insurance and claim information accurately and timely.
  • Organize and prioritize administrative tasks effectively.
  • Maintain claims database and prepare reports related to claims and invoices.
  • Manage communication with internal and external stakeholders via phone and written contact.

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Tufts Medicine XLarge https://tuftsmedicine.org/
10001 Employees
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Job description

Hours: 40 hours - Monday through Friday from 8:00 AM to 4:30 PM

Location: Primarily remote - 1 day onsite required at 800 Washington St in Boston, MA.

Job Profile Summary 

This role focuses on providing administrative and business support to the organization in order to achieve operational goals. In addition, this role focuses on performing the following General Administration duties: Produces documents, collects, records, sorts and files information, handles mail, prepares routine reports, makes travel arrangements, arranges appointments, responds to inquiries, data entry, and operates office equipment.  An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment.  The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.  Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation.

Job Overview 

This role focuses on administrative activities related to Tufts Medicine’s Legal Department.  Activities include the processing of claims inquiries, invoices, generation of system and excel based reports related to claims and insurance, managing phone inquiries, and the distribution of mail.  

Job Description 

Minimum Qualifications: 

1. High school diploma or equivalent. 

2. Two (2) years of more progressively responsible experience processing claims.

Preferred Qualifications: 

1. Associate’s degree. 

2. Insurance experience.

3. Administrative Assistant experience.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list.  Other duties and responsibilities may be assigned. 

1. Handles sensitive, confidential insurance and claim information. Has overall responsibility for the timeliness of reports, as well as the accuracy of the claims information used in all reports, correspondence, input and transaction sheets. 

2. Organizes and prioritizes tasks effectively. 

3. Work involves frequent telephone and written contact with internal and external stakeholders.

4. Enters and maintains information in claims database. Prepares loss runs, incident and reports involving claims.

5. Processes and maintains records of invoices paid, utilizing claims management system and department databases including Excel and SmartSheet.

6. Sets up claim files and prepares initial paperwork in a timely fashion.

7. Maintains collaborative team relationships with peers and colleagues in order to effectively contribute to the working group’s achievement of goals, and to help foster a positive work environment. 

8. Picks up, scans, and distributes mail to intended recipients.

9. Manages the Tufts MC Risk Management phone line and directs caller to appropriate personnel.

10. Maintains office files. 

Physical Requirements:  

1. Professional office environment with typical office requirements such as computers, phones, photocopiers, filing cabinets, etc. 

2. Largely a sedentary role, which involves sitting most of the time, but may involve movements such as walking, standing, reaching, ascending / descending stairs and operate office equipment. 

3. Frequently required to speak, hear, communicate and exchange information. 

4. Able to see and read computers displays, read fine print, and/or normal type size print and distinguish letters, numbers and symbols. 

5. Occasionally lift and/or move up to 25 pounds. 

Skills & Abilities: 

1. Proficiency with Microsoft product suite.

2. Proficiency with SmartSheet and other databases.

3. Excellent math, communication and writing skills. 

4. Familiarity with computers and ability to efficiently and accurately perform data entry. 

5. Ability to maintain accuracy while working under pressure. 

6. Ability to perform independently within department policies and practices. Refers specific complex problems to supervisor where clarification of departmental policies and procedures. 

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Microsoft Office
  • Microsoft Excel
  • Organizational Skills
  • Writing
  • Verbal Communication Skills
  • Time Management
  • Teamwork
  • Problem Solving
  • Mathematics

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