Claims Processor II in Boston, MA at Beacon Health Options

Date Posted: 8/6/2019

Job Snapshot

Job Description

About the Position:

Beacon Health Options is currently seeking a dynamic Claims Processor II to join our team in Boston, MA! The Claims Processor II will be responsible for processing all mental health and substance abuse claims, to include practitioner claims, inpatient claims, and those involving other health insurance and meeting or exceeding department standards relative to productivity and accuracy.

Position Responsibilities:

  • Reviews all claim types to determine completeness and appropriateness for payment, according to existing policies and procedures.
  • Adjudicates claims to completion whether paid or denied, meeting or exceeding department standards relative to production and accuracy.
  • Meets or exceeds departmental productivity standard of 150-200 claim lines a day & meets or exceeds departmental quality standard of 98%.
  • Reviews requests for adjustments, resubmission and written inquiries to determine appropriate resolution, gathers necessary information, and completes claim adjustments according to policies and procedures.
  • Reviews system outputs to ensure correct adjudication. Re-adjudicates or has claims adjusted as necessary.
  • Performs research on pending claims until resolution is reached in order to pay or deny according to policies and procedures.
  • Communicates with internal customers as necessary to obtain information.
  • Identifies unclear or unusual situations and communicates to Supervisor for documentation, new policy and procedure and appropriate follow-through.

Position Requirements:

  • Education: High School diploma or GED equivalent required
  • Relevant Work Experience: 6 months experience with health care claims preferred

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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