Claims Assistant

Claims Assistant

Beyond Health Partners, LLC, a Beyond Risk Management partner company, is an administrative professional to join our dynamic 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.

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. Completes special projects as assigned by management
• Assist with claims reimbursement processes, including distribution of Explanations of Reimbursement
• Completes special projects as assigned by management

Qualifications:

• 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

What We Offer:

• Benefits (100% employee-paid Medical & Dental premiums)
• 401k contribution - 4% company match
• 21 days of PTO + 9 paid national holidays & 1 floating holiday
• Hybrid flexibility after initial training period
• Professional development & continued growth

The candidate must be local to the Beverly, Massachusetts area, as this role is required to be in the office five days per week upon hire. After three months of employment, there is potential for a hybrid schedule, at management's discretion, with no less than three days in the office per week.

We are proud to be an equal opportunity employer. All qualified applications will receive consideration without regard to race, color, religion, sex, sexual orientation, national origin, ancestry, gender, gender identity and/or expression, genetic information, veteran status, disability, citizenship status, marital status, pregnancy, or any other characteristic protected by federal, state, or local employment discrimination laws.