Claims Processor

| Medford

DESCRIPTION SUMMARY: Proactively evaluates invoice submissions from business partners to assess compliance with operational policies and procedures designed to enhance revenues, contain costs or improve operational effectiveness and efficiencies. Responsible for conducting audits for claims operations to assess effectiveness of advanced business rules/controls, accuracy of invoices and payments, compliance with rate agreements and regulations. Gathers and analyzes audit evidence. Comprehends and interprets reject reasons and applies appropriately to Service Provider invoices. Corresponds with Service Providers for additional information needed to process payment. Perform value-added financial, operational, and compliance audits of complex audit projects

 ESSENTIAL FUNCTIONS:

  • Reviews submitted invoices and compares to published service provider rates, using mileage software and business rules in order to determine acceptance or rejection of payment on claim prior to processing.
  • Understands and interprets reject reasons and applies appropriately to service provider invoices.
  • Utilizes processing system to research all claims issues.
  • May authorize stop pay and re-issue of checks to service providers.
  • Researches incorrect purchase orders on service provider claims to determine validity of claim.
  • Corrects documentation to reflect actual service provider utilized during customer service call.
  • Analyzes data obtained for evidence of deficiencies in controls, duplication of effort, extravagance, fraud, or lack of compliance with policies or procedures.
  • Prepares and submits audit findings and makes recommendations to management.

 

EDUCATION: High School Diploma/G.E.D or equivalent work experience.

EXPERIENCE: 1-2 years related work experience in fast paced data entry/transaction processing background and knowledge in automotive industry preferred.

SKILLS: Demonstrates thoroughness, creativity, foresight, and use of sound business judgment in the application of invoice processing principles, corporate policies, and business practices. Possess excellent attention to detail and strong problem solving skills. Analytical ability. Strong PC skills, Technical skills required in word processing, spreadsheet software. Strong Time Management skills. Excellent oral and written communication skills. Must have self-motivation, initiative and ability to handle multiple projects simultaneously.

WORKING RELATIONSHIPS: Communicates with associates, customers and service. Providers in a professional manner. Effectively teams with peers, supervisors and management to achieve corporate and client goals.

ADDITIONAL REQUIREMENTS: Ability to work flexible schedule as business needs dictate. Demonstrates ability to work independently.

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Technology we use

  • Engineering
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Location

We are located in Medford, MA, right at Wellington Station with close access to the MBTA, I-93, Assembly Row, and a stones throw away from Boston.
1 Cabot Road #4, Medford, MA 02155

Insider's spotlight

What projects are you most most excited about?

“We're passionate about making the roads safer with our Driver360 mobile platform. We’ve developed crash detection technology that helps people when they're most in need, and we're using billions of miles of driving data to study crash risk factors and find ways to help people avoid crashing in the first place.”

Michael

Sr Data Scientist, Business Intelligence

How has your career grown since starting at the company?

Agero has provided me the opportunity to work on a number of different products and technologies, from call center to in-vehicle Telematics to web and mobile products. Additionally, I’ve had leadership positions with several groups, including PMO, QA, and now Product Management, which has allowed me to learn and grow throughout my tenure.

Luke

VP, Project Management

Our Engineering/IT teams are moving to the Amazon AWS cloud, which involves a lift/shift for some applications as well as rewriting other applications to be more micro service orientated. This effort is a huge transformation which includes new roles, training and re-thinking how IT operates as a cloud service organization.

Karen

Director, DevOps

Perks of working here

401(K) Matching
401(K)
Casual Dress
Commuter Benefits
Conferences & Training
Dental Benefits
Flex Work Hours
Game Room
Happy Hours
Health Benefits
Onsite Gym
Parking
Tuition Reimbursement
Vision Benefits
Volunteering Opportunities
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