Claims Specialist- ENTRY LEVEL

Claims Specialist

Bedford, MA (100% onsite) 

Purpose

• Review and carry out processes on all out of network claims.
• Duties and Responsibilities
• Responsible for daily review of IDR emails and carrying out responses
• Organize and file IDR emails and responses in corresponding files
• Monitor and track all fee requests from arbitrators
• Compile supporting documentation and send to arbitrator within timeframe
• Review and monitor automation reports to make sure processes are being carried out appropriately
• Sort and file Good Faith negotiations
• Respond to carrier and/or arbitrator inquires in response to good faith negotiations
• Submit claims through necessary state arbitration portals
• Prepare documents using Microsoft Word, Excel, PowerPoint, Adobe PDF
• Complete special projects as assigned
• Support management and assist staff as needed
• Uphold company mission, vision, and values
• Adhere to the Code of Conduct and be familiar with all compliance policies and procedures

Qualifications
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.

Education (Degrees, Certificates, Licenses, Etc.)

• High School Diploma or equivalent combination of education and experience required.
• Computer Skills
• Prior word processing, spreadsheet and internet software experience including proficiency with MS Excel and MS Word and Outlook required.

Experience

• One to two years related experience preferred.

Specific Job Knowledge, Skill and Ability

• Ability to add, to subtract, multiply and divide in all units of measure
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
• Ability to write routine reports and correspondence
• Ability to communicate effectively verbally and in writing
• Ability to apply common sense understanding to carry out instructions
• Specific vision abilities required by this job include close vision
• Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms