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Current Openings:

Health Plans offers an excellent working environment and a competitive wage/benefit package. If you are interested in any of the following positions, please email or fax your cover letter and resume to:

Email: jobs@healthplansinc.com

Fax: 508-329-4814

Customer Support Specialist

Department: Customer Service

Location: Westborough and Quincy, MA

Description:  The Customer Support Specialist is responsible for providing high quality customer service to members, providers and other customers of Health Plans, Inc.  The Customer Support Specialist handles inbound calls regarding questions on medical, dental and other benefits.

The ideal candidate will have a High School Diploma or equivalent; 1 – 2 years’ prior customer service in the healthcare industry preferred.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required.


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Compliance & Privacy Specialist

Department: Compliance

Location: Westborough, MA

Under the direction of the Director of Compliance and Privacy Officer, the Compliance and Privacy Specialist will assist with managing, developing, implementing and monitoring a comprehensive Compliance and Privacy Program in accordance with Health Plans’ policies and federal and state requirements and guidance. The Specialist will work collectively with the Director, senior leadership, and subsidiaries management to ensure that compliance and privacy initiatives are implemented appropriately. As directed, the Analyst will assist with leading efforts implementing, monitoring, and tracking Compliance and Privacy Program elements and providing direction and guidance to subsidiaries personnel for adherence to industry regulations, organization policies, Federal Sentencing Guidelines, HIPAA, and applicable federal and state requirements.

The ideal candidate will have a Bachelor’s Degree and the equivalent of 2 – 4 years’ of full-time experience with compliance, privacy, confidentiality, health information management, or information security in the healthcare industry. Advanced degree (e.g. JD, MHA, MPA, etc.) preferred. Will also possess the following:

  • Strong commitment to maintain confidentiality and privacy.
  • Knowledge of and experience in working with federal and state privacy laws, including those pertaining to access, release of information, and release control technologies.
  • Commitment and ability to:
    • Work in a team-based environment;
    • Handle member interactions/communication with extreme care, patience and consideration; and
    • Create an environment with open channels of communication within the organization with workforce members, members and others.
  • Possess excellent organization, attention to detail, facilitation, technical and analytical skills. Can gather relevant information systematically, break down problems into simple components and can make sound decisions.
  • Approach problems with curiosity and open-mindedness and offer new ideas, solutions and/or options. Demonstrate discretion, diplomacy, and good judgment.
  • Possess strong communication and presentation skills; clearly and concisely express ideas in groups and one-to-one conversations, formal and informal documents. Adapt writing and communications styles to fit the audience.
  • Project management and change management skills; ensuring projects come to fruition from inception to completion.
  • MS Office (Word, Excel, Access, PowerPoint) expertise and knowledge of or ability to learn electronic medical record auditing software.

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Account Manager

Department: Client Services

Location: Westborough or Woburn, MA; Portland, ME

The Account Manager (AM) is responsible for coordinating and managing the plan implementation for new clients, as well as handling the overall servicing of account issues for existing clients. For new clients, the AM will coordinate the plan implementation by producing educational materials, conducting benefit meetings, designing and communicating plan design. As the primary contact for the group representatives and brokers, the AM works closely with internal staff to communicate service issues; coordinate plan building design; resolve claim payment issues; provide general account service; and provide support to Sales Manager/Director. The AM position requires significant travel as he/she conducts service meetings with each client. 

The ideal candidate will have a Bachelor’s Degree or equivalent experience. Must have 3 – 5 years’ experience in client services/client-facing roles in the healthcare industry. Must work collaboratively with other departments to resolve issues, have strong decision and problem-solving skills, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. 

 

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Customer Service Supervisor

Department: Customer Service

Location: Quincy, MA

Description: Health Plans, Inc. is seeking a dynamic, self-motivated individual with demonstrated experience as an effective leader and coach to join our team as the Supervisor of Customer Service. In this role, the Supervisor is responsible for overseeing all customer service functions across multiple locations. The Supervisor will coach, mentor and develop high performing Customer Service Representatives.

Responsibilities include assisting with problem resolution and supporting front-line staff. The Supervisor is a resource for internal departments in researching and resolving complex customer situations, and is responsible for the day-to-day oversight of phone queue performance and making necessary adjustments to meet optimal service levels. In addition, the Supervisor monitors and addresses performance issues directly with staff including creating and delivering annual performance reviews. This position will support department leadership in reporting and forecasting call center statistics to ensure appropriate staffing levels.

The ideal candidate will have a Bachelor’s Degree or equivalent experience.  Must have 3 – 5 years’ experience in a customer service/call center environment, preferably in the healthcare industry. Prior team lead/supervisory experience preferred. Must work collaboratively with other departments to resolve issues, have strong decision and problem-solving skills, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. 

 

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Reporting Analyst

Department: Sales Reporting

Location: Westborough,MA

Description: Responsibilities include responding to report requests from internal and external customers. Create and/or run monthly, quarterly or ad-hoc reports as requested.  Prepare client reporting packages including loss ratio reports. Duties may also include extracting and analyzing results from data mining software tool. The Reporting Analyst works closely with members of the Reporting team as well as other Health Plans’ staff in order to meet the reporting needs of internal departments as well as our clients, brokers, and reinsurance carriers.

The ideal candidate will have a High School Diploma or equivalent, and at least 1 – 2 years’ of experience compiling reports, preferably in the finance/banking or healthcare industry.  Candidates must have knowledge and experience with healthcare data and claim adjudication, and be apply to comprehend and communicate reinsurance contracts. Must also be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Advanced skills with Microsoft Word and Excel required.  


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Reinsurance Analyst

Department: Reinsurance

Location: Westborough, MA

Description: The Reinsurance Analyst is responsible for calculating and submitting specific and aggregate filings to the reinsurance carriers. The Reinsurance Analyst will act as liaison between the reinsurance community and Health Plans, Inc.

The ideal candidate will have a High School Diploma or equivalent. Must have 1 - 2 years’ of processing experience, preferably within the self-insured health insurance industry. Must have knowledge of hospital and provider billing procedures; have the ability to interpret and understand plan document language and stop-loss contracts.

Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. 

 

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Precert Coordinator

Department: Care Management Services

Location: Westborough, MA

Description: The Precert Coordinator will effectively accept and respond to calls and inquiries regarding pre-certification, Case Management, and Disease Management services. Initiate and complete notifications which do not require evaluation or interpretation of clinical data. Begin pre-certification processes by initiating system files (or cases) for clinical reviewers.  Adhere to Care Management policies and procedures, URAC, state and federal regulations. Provide superior quality customer service to internal and external customers. Will also perform a variety of routine clerical duties (i.e., data entry, filing, sorting mail, assembling and distributing mailings, receiving, storing and distributing supplies).

The ideal candidate will have a High School Diploma or equivalent; Associate’s or Bachelor’s Degree preferred. 2 + years’ prior customer service in the healthcare industry preferred with working knowledge of medical and claims terminology. Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. Bi-lingual (English and Spanish) a plus.

 

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Financial Operations Support

Department: Accounting/Financial Operations

Location: Westborough, MA

Description: The Financial Operations Support position will be responsible for a variety of diverse tasks. These tasks include organizing, preparing and monitoring return checks, assisting with various tasks related to our client claim funding process, preparing letters to clients, downloading and formatting various bank statements documents and monthly check registers to support monthly bank account reconciliations, and generating and maintain various reports.  This position will interact with all departments within the company, specifically Corporate Accounting and Client Fund Accounting.

This is an entry-level position with the opportunity to be exposed to more financial in nature processes.

The ideal candidate will have previous experience in a fast-paced office.  Banking or experience in the healthcare industry a plus.  Candidates must be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required.

 

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Imaging Specialist

Department: Imaging Services

Location: Quincy, MA

Description: The Imaging Specialist is responsible for accurate scanning of documents. In our Imaging Services area, this individual will sort all incoming daily mail, distribute all non-claim mail, and open and sort all claim mail; scan all standard claim forms and claim supporting documents. 

In addition, the Imaging Specialist provides receptionist support on a regular basis and as needed basis.

The ideal candidate will have a High School Diploma or equivalent; prior customer service experience a plus. Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. Valid driver’s license required.

 

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Claims Examiner

Department: Claims

Location: Westborough, MA

Description: The Claims Examiner is responsible for the processing of medical claims in accordance with applicable plan benefits. This position will handle of a specific block of group plans and is integral in maintaining the client/customer relationship with those group plans.  The Claims Examiner will also assist claimants, providers and/or clients with problems or questions regarding their claim and/or policies.

The ideal candidate will have a High School Diploma or equivalent; prior experience in claims processing, knowledge of medical terminology and/or billing and coding preferred. Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required. 

 

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Enrollment Specialist

Department: Enrollment

Location: Westborough, MA

Description: The Enrollment Specialist is responsible for timely, accurate entry of enrollment activity for all of Health Plans Inc.’s accounts.  The Specialist will interact directly with coworkers within the department as well as with various staff members from other departments.  Will process enrollment data via variance reports generated from 834 file transmissions, paper and email submissions, and transactions submitted through multiple databases (WebECI and CSIPac).

The ideal candidate will have a High School Diploma or equivalent; prior experience in healthcare industry or an enrollment position preferred.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required. 

 

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Plan Building Specialist

Department: Technical Resource Unit

Location: Westborough, MA

Description: The Plan Building Specialist is responsible for new business set-up, renewal updates and day-to-day maintenance of data within the Company’s Healthware system to provide accurate claim processing and administration of benefits.

The ideal candidate will have a High School Diploma or equivalent; 1 – 2 years’ related experience.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required. 

 

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