Claims Assistant

Beyond Risk Management Inc•Beverly, MA

14h•Hybrid

About The Position

Beyond Health Partners, LLC, a Beyond Risk Management partner company, is seeking a dynamic administrative professional to join their claims team. As a Claims Assistant, you will manage administrative functions for the claims department while learning the fundamentals of the medical stop loss industry and providing backup administrative support across other departments, as needed.

Requirements

Bachelor's degree from a four-year college or university, or 1-3 years of relevant work experience in an administrative role
Strong analytical skills with the ability to interpret complex claims data
Ability to problem-solve and apply critical thinking skills to identify solutions
Willingness and flexibility to learn new skills, and to assist various divisions within the company, as needed
Excellent attention to detail and accuracy in data entry and documentation
Strong communication skills, both verbal and written, with the ability to interact professionally with internal and external parties
Proficiency with Microsoft Office applications (Excel, Word, Outlook, PowerPoint), and ability to learn new computer systems and technology quickly
Ability to work independently and collaboratively in a fast-paced, deadline-driven environment
A positive attitude, commitment to teamwork, and an eagerness to learn are critical to success in this role

Responsibilities

Manages the Claims mailbox for multiple programs, promptly and accurately logging initial and subsequent claims submissions, notices, and reporting in the claims system
Acts as the first line of contact for the Claims department, appropriately replying to communications and inquiries from external partners
Format claims detail spreadsheets and import to the appropriate claim submission
Accurately refer notices to appropriate risk management specialists, in accordance with guidelines
Maintain accurate records of monthly reporting received for each policyholder, following up with brokers and TPA partners for missing reporting to ensure records are current
Train cross-functionally across the organization to develop a deep understanding of the medical stop loss industry, and to provide assistance during periods of high-volume activity.
Assist with claims reimbursement processes, including distribution of Explanations of Reimbursement
Completes special projects as assigned by management