WELLFLEET

Compensation

Full Description

Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace. Founded in 1993 as Consolidated Health Plans (CHP), Wellfleet, headquartered in Springfield, Mass., is one of the nation’s leading providers of health and accident insurance products to the higher education market. Join our rapidly growing and fast paced health insurance organization in the Springfield area. The ideal candidate in this position will assist the Claims Supervisor in the technical and operational functions of the claims unit, including but not limited to; compliance with company standards and industry best practices; to ensure consistent delivery of quality services; assist with staff training and development and questions. Responsible for certain administrative duties associated with our accounts. In this role, you will… • Communicate with Clients, Policyholders and Agents as required • Assist Account Managers with questions as necessary • Works with staff on professional development and identifying career goals and aspirations of team members • Review of reports (audit, inquiry etc.…) to identify trends and areas for process improvement and identifies additional training opportunities • Contribute agenda items for weekly claims meeting to foster a culture of focusing on ways we can improve our services to better meet the needs of our customers • Must have thorough understanding of all equipment, methods, and procedures • Good oral and written communication skills and is expected to give clear communications to staff • Develops and implements appropriate training programs for Claims personnel to maximize their performance and skills in consult with HR and the Claims Supervisor • Must maintain confidentiality • Ability to handle difficult situations and persons in a positive and professional manner • Ability to motivate others to reach their potential and drive results • Self-motivated with the ability to work independently, with very little direction • Monitor and keep accurate track of timesheets, PTO while meeting company staffing needs • Assist Claims Supervisor with performance reviews • Participates in the screening and hiring process • Ensure staff is responding timely to all appeals and DOI complaints that need reprocessing • Ensure staff are processing claims accurately and timely • Ensure staff is responding timely to inquiry forms • Perform random Claim Audits as needed • Ability to handle special projects • Establish and maintain a high level of positive working relationships with internal and external customers • Keep current with benefits • Meet KPM’s and operating plan deliverables • Ensure client specific and company SLA’s are met • Keep management informed of problems and issues • Handle escalated issues • Perform other duties as assigned We are looking for candidates with… • Bachelor’s Degree is preferred, or a minimum of 5 years claims processing experience • Must have recent experience in the health insurance industry to support our clients • Must have demonstrated experience as a leader • Knowledge and familiarity of CPT, HCPC, ICD-10 codes and medical terminology • Excellent oral, written and interpersonal communication skills • Ability to lead and remain calm and professional when facing challenges • Demonstrates the ability to work well in a team environment • Ability to be flexible in prioritizing workloads to meet changing deadlines • Ability to handle constantly changing situations with ease • Excellent skills in MS office products Why Wellfleet? Here at Wellfleet, we foster a culture of growth that enables engaged and high-performing professionals to be empowered to deliver our mission and vision. Our employees are a team devoted to providing customer service that exceeds expectations of our members and clients. Successful team members continually look for ways to improve product delivery and value. Wellfleet offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement, and business casual dress. Are you interested in exploring a career at Wellfleet? Explore our open positions. #LI-KS1 #LI-Remote General: Wellfleet is part of the MedPro Group family. As such, all Wellfleet team members are employees of MedPro Group Inc. We are an Equal Opportunity Employer. Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace. The annual gross base salary range is $55,000 to $67,000. This range anticipates the low and high end of the salary for this position. Actual salaries will vary and are based on factors such as a candidate’s qualifications, skills and competencies. Salary is one component of Wellfleet’s total compensation and benefits package, which includes medical, vision and dental insurance options, life and accident insurance, 401(k), and short-term and long-term disability insurance. For a more detailed overview, visit our careers website at: wellfleetinsurance.com/about/careers. #LI-KS1