Complex Claims Processor - (Watertown, MA)

The Complex Claims Processor is responsible for the timely and accurate processing of Medicare claim inventory as assigned by the Mamager of Claims. Using analytical and issue solving abilities, the Complex Claims Processor is expected to fully research and resolve all complex issues and problem codes for each claim. EDUCATION: - 18-24 mnths background as a Tufts Health Plan Core Claims Processor or similar claims processing or customer service background required - Associates degree or equivalent business background in a claims/customer service healthcare environment preferred. BACKGROUND: SKILL QUALIFICATIONS: Background with Tufts Health Plan's internal applications, such as TAHPMaster, Macess, Infolink, (CMT) preferred. Understanding of managed care concepts and a strong understanding of CPT, ICD-9 (ICD-10), HCPCS coding guidelines and CMS1500 & UB04 billing forms preferred. Job necessitates strong issue solving and analytical skills with the expertise to multi-task.