Join a growing health plan that’s been serving communities for over 25 years.
About WellSense Health Plan
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997 as Boston Medical Center HealthNet Plan, our mission is to provide high-quality health plans and services that work for our members, no matter their circumstances.
Schedule
- Full-time, remote position
- Monday–Friday
- Ability to work overtime during peak periods may be required
Responsibilities
- Evaluate and process claims in accordance with company policies, productivity, and quality standards
- Interpret and process routine claims, including CMS 1500 and UB04 forms
- Review and analyze system reports to identify and resolve errors before adjudication
- Escalate aging issues and provider billing problems to management
- Maintain current knowledge of member benefits, policies, provider contracts, systems, and regulatory requirements
- Meet or exceed productivity and quality goals
Requirements
- High school diploma or equivalent required; Associate’s degree or some college coursework preferred
- 2+ years of experience in managed care claims processing preferred
- Working knowledge of medical terminology, CPT4, HCPCS, ICD9 coding, and HIPAA regulations
- Familiarity with Microsoft Office; FACETS experience preferred
- Ability to meet deadlines and maintain accuracy under production standards
- Strong organizational skills and attention to detail
Benefits
- Competitive salary
- Comprehensive health, dental, and vision insurance
- Generous paid time off and holidays
- 401(k) with employer match
- Career development and internal mobility opportunities
- Inclusive, mission-driven culture
Compensation
Pay is competitive and based on experience, skills, and location.
About the Hiring Process
Qualified candidates will complete an application and may be invited to:
- A behavioral interview with Talent Acquisition
- A technical or competency assessment
- An interview with the Hiring Manager
Additional steps may be added as needed.
Equal Opportunity Employer
WellSense is committed to diversity and inclusion. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status. WellSense participates in E-Verify to confirm employment eligibility.
Important Notice on Employment Scams
WellSense only accepts applications through its official website. We will never request payment, equipment purchases, or conduct interviews via text or social media. For tips on avoiding employment scams, visit the FTC’s website.
Ready to make an impact with a company that puts people first?
Happy Hunting,
~Two Chicks…