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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

Payment Processing Specialist

Department: Payment Processing

Location: Westborough, MA

The Payment Processing Specialist is responsible for the facilitation of the payment process across Health Plans, Inc.’s client base. Duties include the following:

  • Coordinate claim, broker and vendor payment process as it relates to clients’ plan expenses.
  • Coordinate invoicing process related to client and member billing.
  • Compile and audit various daily reports pertaining to the payment process.
  • Research and resolve remittance questions and situations.
  • Communicate with claim examiners, account managers and various other departments according to internal and client needs.
  • Communicate with outside vendors to insure the issuance and integrity of checks and EOBs created during the check run process.
  • Facilitate cross-departmental projects pertaining to billing, funding and enrollment that impact the validity of payments issued by the department.
  • Prepare management and client reports as needed.

The ideal candidate will have a High School Diploma and 2+ years’ related experience, preferably 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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System Specialist

Department: Billing & Payment Configuration

Location: Westborough, MA

The System Specialist is responsible for new business set up, renewal updates and day-to-day maintenance of data within the Healthware System required to provide administrative services including enrollment, billing, reporting, coordination of vendor remittance and end of day claim payment process. 

The ideal candidate will have a High School Diploma or equivalent; 2 - 4 years’ prior experience in billing and configuration system roles in the healthcare industry. Must be able to work independently and as part of a team, be detailed, analytical, 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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Programmer Analyst

Department: Information Systems

Location: Westborough

Description: The Programmer Analyst is an information systems professional who designs, documents, develops, tests, implements, and maintains software systems and programs that support the Health Plans, Inc. operational environment. Objectives and specifications are supplied by the user. The Programmer Analyst validates the system specifications for completeness and interactions with other systems already in place or planned. If anomalies are discovered, the Programmer Analyst will negotiate with the user to modify the specifications and/or objectives to insure the program or system developed will satisfy the desired objectives and not adversely affect other systems. Programs may be very complex in nature, coded in various programming languages, and implemented on multiple hardware platforms and operating systems.

The ideal candidate will have a Bachelor’s Degree or equivalent experience, and 3–5 years of programming experience, preferably in the healthcare industry with knowledge of HIPAA Transaction Standards. Must have in-depth knowledge of the following: Microsoft.Net technologies including Visual Studio, SQL Server, SQL Express, Store Procedures, Web Services, VB.Net, and XML; X12 EDI formats, SSRS, and SSIS.

Must work collaboratively with colleagues and 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. Proficient with Microsoft Word and Excel; experience with Java Script and AJAX a plus.

 

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Enrollment Support

Department: Enrollment

Location: Westborough,MA

Description: This position provides support functions associated with the Enrollment Department. Timely, accurate processing of all functions is integral to this position. The individual will interact directly with coworkers within the department, various staff members from nearly all other departments as well as clients and members. 

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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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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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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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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