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Healthcare Claims Specialist

Healthcare Claims Specialist

MMC Group LPEast Hartford, CT, US
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Job Description

Job Description

Job Title :  Transaction Processor Associate II (Healthcare Claims Specialist)

Location :  Onsite, East Hartford, CT

Employment Type :  Full-Time | Monday – Friday (with occasional overtime) No weekends

Position Overview

The  Transaction Processing II - Healthcare Claims Specialist  plays a key role in supporting transaction processing projects by researching, analyzing, and updating consumer information across multiple systems. This position requires strong attention to detail, organizational skills, and a positive approach to meeting deadlines in a fast-paced environment.

Primary Responsibilities

  • Process case maintenance transactions accurately and efficiently within established procedural guidelines.
  • Evaluate and determine eligibility of medical expenses for specific programs.
  • Communicate professionally with clients and consumers via phone, email, and written correspondence.
  • Enter and update consumer information into eligibility determination systems with accuracy.
  • Consistently meet or exceed daily productivity and quality standards as defined in the Quality Assurance Plan (QAP).
  • Provide excellent customer service, maintaining professionalism with all internal and external partners.
  • Maintain working knowledge of procedures, guidelines, and operating systems required for daily tasks.
  • Ensure timely completion of assignments in compliance with contractual requirements.
  • Exhibit reliability, punctuality, and a positive attitude towards all assigned tasks.
  • Adhere to attendance policies and contribute to a positive team environment.

Qualifications

Education & Experience :

  • College degree preferred.
  • Previous experience in eligibility determination, transaction processing, or a related field strongly preferred.
  • Required Skills & Abilities :

  • 6 months or more Call Center experience required within the last year
  • Minimum typing speed of 40 words per minute.
  • Strong organizational and prioritization skills with flexibility to adapt to changing priorities.
  • Proficiency with standard PC systems and software applications (training provided if needed).
  • Analytical mindset with effective problem-solving abilities.
  • High attention to detail and accuracy, with the ability to identify and correct data quality issues.
  • Ability to maintain a consistent work pace and meet production and quality goals.
  • Self-motivated and able to work independently after initial training.
  • Demonstrates professionalism and commitment to achieving team and individual goals.
  • Work Environment

  • Work is typically performed in an office setting.
  • Overtime, evenings, and occasional weekend hours may be required.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
  • Company Description

    Throughout the past 30 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries.

    We have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate, to the right client, for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.

    MMC is a privately owned business with corporate headquarters in Irving, Texas. With 2,000+ employees, working in 40+ states, MMC is able to support all United States locations, and some international locations.

    We appreciate your interest in reviewing this particular position and we encourage you to visit our website where you can always search and apply for opportunities at www.mmcgrp.com

    Get started on your career journey today! Apply to become a part of the MMC Team!

    We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

    Company Description

    Throughout the past 30 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries.\r\nWe have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate, to the right client, for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.\r\nMMC is a privately owned business with corporate headquarters in Irving, Texas. With 2,000+ employees, working in 40+ states, MMC is able to support all United States locations, and some international locations.\r\nWe appreciate your interest in reviewing this particular position and we encourage you to visit our website where you can always search and apply for opportunities at www.mmcgrp.com\r\nGet started on your career journey today! Apply to become a part of the MMC Team!\r\nWe are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

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    Healthcare Specialist • East Hartford, CT, US

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