Job Description

Ready to help us transform healthcare? Bring your true colors to blue.

***This position is eligible in the following persona(s): Mobile***

What we need:
An individual who has excellent written and verbal communication skills to collaborate with internal and external departments, including vendors and providers, to retrieve medical records for our various programs while protecting our members information.

Your Day to Day:
1. Reconcile chart receipts to organizations; reviewing claims to determine which charts should be pursued. Generate panel lists to send to provider offices.
2. Investigate and resolve discrepancies. Maintain, update and purge files.
3. Review records and transactions for accuracy.
4. Contact provider offices with a high degree of professionalism and confidence to communicate expectations, charts required, etc.
5. Perform processing tasks such as: sorting incoming mail, preparing documents for scanning, retrieving information from Right Fax, moving documents as appropriate to the NAS server, copying data, posting data in logs, compiling records, and routing / distributing documents following specific procedures
6. Identify, investigate, and resolve issues related to incoming correspondence.
7. Special projects as assigned

We\xe2\x80\x99re Looking for:
Someone who exhibits a spirit of teamwork, contributes ideas for team success, understands the importance of meeting project deadlines and understands importance of PHI and HIPAA.

What You Bring:
A positive upbeat attitude and willingness to learn new things. Be able to contribute to the success of this team with good communication skills and be able to collaborate with internal and external partners with those skills.

What You\xe2\x80\x99ll Gain:
An in-depth knowledge of Risk Adjustment policy and procedures, government audits, building relationships with various vendors and providers, and get an understanding of EMR/EHR medical record systems.

It is our mission at Blue Cross Blue Shield of Massachusetts to foster a culture that enables associates to do their best work while living happy and healthy lives. That\'s why we offer you a variety of ways to support your best physical, emotional, financial, and social well-being. For more information on our benefit offerings, visit https://careers.bluecrossma.org/us/en/benefits

#LI-HYBRID

Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above

Location Hingham Time Type Full time

WHY Blue Cross Blue Shield of MA?
We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don\xe2\x80\x99t hesitate to apply. We\xe2\x80\x99d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It\xe2\x80\x99s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you\xe2\x80\x99d like to be a part of, we\xe2\x80\x99d love to hear from you. You can also join our Talent Community to stay \xe2\x80\x9cin the know\xe2\x80\x9d on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).

Blue Cross Blue Shield of Massachusetts, has a COVID-19 vaccination requirement. Your offer of employment is dependent upon either being fully vaccinated for COVID-19 or an accommodation based on a disability or sincerely held religious belief, practice, or observance by submitting a request to Human Resources.