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Fallon Health
Fallon Health

20 Fallon Health Claims Processor Jobs Hiring Near You

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Fallon Health Jobs Information

Do workers at Fallon Health get paid breaks?

Sometimes. Only some people get paid breaks.
56% of people say they don’t get paid breaks.
Based on data from 9 people who took the Breakroom Quiz between December 2024 and June 2026.

Does Fallon Health pay people when they’re sick?

Yes. Most people get paid when they’re sick.
91% of people say they would get paid if they were sick but scheduled to work.
Based on data from 11 people who took the Breakroom Quiz between December 2024 and June 2026.

At Fallon Health, are sick days and vacation days separate paid time off?

Sick days and vacation days are used from the same paid time off.
100% of people say they have to use vacation days when they’re out sick.
Based on data from 9 people who took the Breakroom Quiz between August 2025 and June 2026.

Is the health insurance from Fallon Health affordable enough for their workers?

Most people say the health insurance costs are okay.
100% of people say the health insurance costs are okay
Based on data from 7 people who took the Breakroom Quiz between April 2025 and June 2026.

Do people get paid time off at Fallon Health?

Most people get paid time off work.
100% of people say they get paid time off.
Based on data from 9 people who took the Breakroom Quiz between August 2025 and June 2026.

Do workers at Fallon Health worry about hours?

Most people don’t worry about getting enough hours.
80% of people report they don’t worry about getting enough hours.
Based on data from 5 people who took the Breakroom Quiz between December 2024 and September 2025.

How easy is it to get time off at Fallon Health?

Most people find it easy to get time off.
70% of people report it’s easy to get time off.
Based on data from 10 people who took the Breakroom Quiz between December 2024 and June 2026.

Do Fallon Health managers change schedules at the last minute?

Some managers change people’s schedules at the last minute.
40% of people say their manager changes their shift schedule at the last minute.
Based on data from 5 people who took the Breakroom Quiz between December 2024 and September 2025.

Do jobs at Fallon Health spill into time workers aren’t paid for?

Rarely. The job doesn't usually spill into unpaid time.
0% of people report that their job takes up time that they don’t get paid for.
Based on data from 5 people who took the Breakroom Quiz between December 2024 and September 2025.

How easy is it to take sick days at Fallon Health?

Most people find it easy to take sick days.
92% of people report that it’s easy to take time off if they are sick.
Based on data from 12 people who took the Breakroom Quiz between December 2024 and June 2026.

Is working at Fallon Health good if you’re a parent or caregiver?

Most parents and caregivers say this is a good place to work.
100% of people who care for a child or other relative report this is a good place to work.
Based on data from 8 people who took the Breakroom Quiz between January 2025 and January 2026.

Do people at Fallon Health feel treated with respect by their managers?

Most people feel treated with respect by their managers.
83% of people say they’re treated with respect by their managers.
Based on data from 12 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people at Fallon Health get to take their breaks without interruption?

Most people get breaks without interruption.
70% of people report that they get to take their breaks without interruption.
Based on data from 10 people who took the Breakroom Quiz between December 2024 and June 2026.

Is it stressful to work at Fallon Health?

Most people feel stressed out here.
85% of people say they often feel stressed out at work.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people at Fallon Health enjoy their jobs?

Most people enjoy their job.
80% of people report they enjoy their job.
Based on data from 10 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people at Fallon Health recommend working with their team?

Only some people recommend working with their team.
54% of people report that they wouldn’t recommend working with their immediate team to a friend.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people get enough training when they start at Fallon Health?

Some people didn’t get enough training when they started.
46% of people report they didn’t get enough training when they started working here.
Based on data from 13 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people get support to advance at Fallon Health?

Most people aren’t given support to advance their career here.
In the last year, 75% of people report not being given support to advance their career here.
Based on data from 12 people who took the Breakroom Quiz between December 2024 and June 2026.

Do people think Fallon Health’s headquarters understands what’s happening where they work?

Some people think headquarters doesn’t understand what’s happening where they work.
67% of people think that this employer’s headquarters or owners don’t have a good understanding of what’s really happening where they work.
Based on data from 9 people who took the Breakroom Quiz between January 2025 and June 2026.

Do workers feel well informed about how Fallon Health is doing?

Most people feel well informed about how the company is doing.
75% of people feel that they are kept well informed about how the company is doing as a whole.
Based on data from 12 people who took the Breakroom Quiz between December 2024 and June 2026.
What other companies are hiring for Claims Processor jobs?
What are the most popular jobs at Fallon Health?
What are the most popular categories at Fallon Health?
Infographic showing various Claims Processor job openings at Fallon Health in the United States as of August 2026, with employment types broken down into 11% As Needed, 86% Full Time, and 3% Part Time. Highlights an 84% Physical, 5% Hybrid, and 11% Remote job distribution.

Summit Eldercare Service Coordinator

Fallon Health

Worcester, MA • On-site

$23.20/hr

Other

Medical, Life

Posted 11 days ago

Fallon Health rating

7.3

Company rating: 7.3 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

Overview
About us:
Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation's top health plans for member experience, service, and clinical quality.
Fallon Health's Summit ElderCare® is a Program of All-Inclusive Care for the Elderly-PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique.
Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE- in the region.
Brief summary of purpose
Provides coordination, scheduling and problem resolution for all approved home care services for SE participants. Documents all actions in a timely manner in an electronic medical record (EMR). Supports other program administration needs as assigned.
Responsibilities
Primary Job Responsibilities
  • Coordinates and schedules home care services to implement the plan of care established by the interdisciplinary team (IDT).
  • Works collaboratively with Home Care nurses and other staff, vendors, participants and families to support SE's mission, promote high quality care and service as well as positive internal and external customer relations.
  • Communicates with homecare agencies and other vendors to coordinate services including initial orders, changes, cancellations and resumption of services.
  • Demonstrates professionalism and acts as an ambassador for Fallon Health and Summit ElderCare at all times
  • Emails or faxes open case needs to homecare agencies as required.
  • Effectively utilizes established systems and procedures to identify problem cases and alert management of need for additional interventions.
  • Follows up on all non-assigned cases as required until services are secured.
  • Documents all vendor authorizations and service coordination efforts in the EMR and other identified systems as assigned.
  • Documents all participant related telephone calls in the EMR.
  • Faciliates timely delivery of service authorizations to vendors.
  • Maintains a positive working relationship with peers, vendors and other staff.
  • Maintains an accurate record of participants' home care services in a designated format.
  • Utilizes established systems to track data as assigned. Prepares reports as requested.
  • Conducts periodic audits of claims paid to ensure services were authorized by the IDT and facilitates resolution of identified issues.
  • Is expected to be a part of the weekend on call rotation.
  • Performs photocopying, faxing and other clerical duties as required.
  • Performs other duties as assigned by Operations Manager and other leadership staff.

Qualifications
Qualification requirements
Education
  • High School diploma or equivalent preferred, or substantial work experience.

License/Certification
n/a
Experience
  • Past home care coordination experience highly desirable. Previous customer service experience preferred.
  • Excellent telephone and customer service skills
  • Relationship building skills
  • Strong organizational skills
  • Strong work ethic
  • Strong basic computer and office skills specifically with Microsoft Office
  • Ability to plan work and meet required deadlines
  • Ability to work in a fast-paced environment
  • Basic math skills
  • Ability to learn insurance terminology related to authorizations, claims and payments
  • Ability to perform multiple tasks efficiently and accurately, to proactively identify problems and resolve issues with minimal supervision.

Pay Range Disclosure:
  • In accordance with the Massachusetts Wage Transparency Act, the pay for this position is budgeted for $23.20 per hour which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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