Claims Intake Processor I

Under immediate direction the Claims Assistant will be responsible to performs general clerical work requiring use of standard office equipment such as a photocopier, PC, scanners, etc. Performs related office duties such as sorting, batching and filing the mail. The following is characteristic of this classification, but duties may vary from department or assigned area. Responsibilities also include the receipt and proper distribution of paper claims via US and inter-office mail.

Key Responsibilities/Duties – what you will be doing

• Receive, open, and distribute incoming mail.
• Sort and batch claims/referrals/PPDs following sorting guidelines for Commercial Claims, Senior Products and Public Plans.
• Maintain/ update Certified mail receipts log.
• Operate high speed scanner to scan prepared batches.
• File scanned documents following retention schedule, and request secure recycle of documents.
• Return mail to provider following return mail requirements.
• Winscan documents using desktop scanner into MACESS folders following winscan request.
• Keep daily production log of various duties performed.
• Promptly identify and resolve any exception issues and/or report to Supervisor.
• Maintain daily production standards as established by the department.
• Establish and maintain solid working relationships.
• Assist in department special projects as needed.
• Interacts positively with other departments
• Attends Claims Department staff meetings.
• Demonstrates professional behavior.
• Work with other departments within the claims area, re-entering special claims.

Qualifications – what you need to perform the job

• Ten-key experience and typing is beneficial. Data Entry/ PC experience in a production environment. Prior office work experience with medical terminology is preferred.
• Ability to prioritize, multi task and problem solve a must.
• Excellent verbal communication skills required.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law

Req ID: R7381