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Job ID : 35577

Location : BOSTON, Massachusetts

Company Name : JPS TECH SOLUTIONS

Job Type : Contract

Industry : Information Technology

Salary : $60 - $65  per hour

No. of Positions : 2-4


Required Skills : Systems Analysis.

Benefits : None of These


Job Description :

Role:-Systems Analyst
Location:-BOSTON, Massachusetts
Position type :- Contract
No of positions :- 1

Job Description:
Responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.). Primary duties may include, but are not limited to: Able to handle more complex claim with a good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits,& healthcare terminology. Good working knowledge of claims and products, including the grievance and/or re-consideration process. Excellent knowledge of the various operations of the organization, products, and services. Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement. Researches and analyzes claims issues. Responds to inquiries, may involve customer/client contact. Requires a HS diploma or equivalent and a minimum of 1 year of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.); or any combination of education and experience which would provide an equivalent background.

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