Claims Resolution Specialist
About The Position
We are seeking a high-energy, goal-oriented Claims Resolution Specialist to join our growing team in Andover, Massachusetts. Under general supervision, the Claims Resolution Specialist performs a variety of professional duties in support of IWP’s pharmacy services. This position is responsible for expediting payment from workers’ compensation insurance carriers, monitoring electronic billing rejections, and maintaining accounts receivable. This is a phone-based position, Monday through Friday, from 8:30 am to 5:00 pm. Hybrid Work Eligibility: This role is onsite during the initial training period, with the possibility of transitioning to a hybrid schedule after 6–9 months, contingent upon successful completion of training, satisfactory performance, and manager approval. Please note that hybrid eligibility is not guaranteed and may be adjusted based on business needs.
Requirements
- An experienced customer service professional with the ability to work in a fast-paced group
- An investigative mind with outstanding attention to detail
- A professional demeanor with strong oral and written communication skills
- Proven experience generating and analyzing complex reports
Nice To Haves
- Workers’ compensation experience
- Knowledge of medical terminology
- Collections, claims processing, and subrogation experience
- Bilingual in Spanish (conversational and written)
Responsibilities
- Review, investigate, and analyze claims to maximize recovery
- Monitor electronic billing rejections and take appropriate action
- Ensure proper filing of invoices and monitor billing statuses less than 60 days outstanding
- Develop and maintain internal systems for data collection and entry, financial analysis, and report generation; create and update spreadsheets and logs as necessary
- Serve as a liaison between insurance carriers, pharmacy benefit managers, patients, and internal company divisions
- Negotiate settlements with insurance carriers within their granted settlement authority level as needed
- Pursue subrogation and arrange for salvage to obtain maximum recovery
Benefits
- Monthly engagement events and larger annual celebrations (tent party, summer BBQ, Family Fun Day)
- Tuition reimbursement and an internal-first job posting philosophy to support career growth
- Onsite fitness center, free parking, and a competitive benefits package
- A positive, inclusive environment where employees feel valued, supported, and empowered
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
