Start your health insurance career with a fully remote role that actually trains you and keeps the work straightforward. As a COB Claims Specialist I, you’ll process claims behind the scenes so members get the right coverage and providers get paid correctly.
About WellSense Health Plan
WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicaid, Medicare, and Individual & Family plans. Founded as Boston Medical Center HealthNet Plan more than 25 years ago, WellSense focuses on delivering health coverage that works for real people, no matter their circumstances. The organization is known for its community-minded approach, strong benefits, and long-term stability in the regional health insurance market.
Schedule
Full-time, fully remote position.
Standard office hours with the ability to work overtime during peak periods.
Role is computer-based and performed in a typical home office environment with regular, reliable attendance expected.
What You’ll Do
- Review and process claims that involve Coordination of Benefits (COB), ensuring they adhere to COB rules and payment order.
- Update and maintain member coverage records in claims systems and COB databases.
- Process Medicaid claims in alignment with COB protocols, federal, and state regulations.
- Communicate with healthcare providers to resolve claim issues and answer processing questions.
- Collaborate with internal teams to address claims-related discrepancies and support overall operational effectiveness.
- Perform other claims-related duties as assigned under close daily supervision.
What You Need
- High school diploma or GED.
- At least 2 years of claims processing experience.
- At least 2 years of health insurance experience with familiarity in industry terminology.
- Basic understanding of health insurance COB rules, including Commercial, Medicaid, and Medicare guidelines.
- Ability to navigate multiple computer systems and work comfortably with Microsoft Office tools.
- Strong attention to detail, accuracy, and ability to follow written instructions.
- Clear, professional oral and written communication skills.
- Ability to work independently while functioning as part of a team.
- Preferred: Two consecutive years of work history and one year of Cognizant claims processing experience (Facets, QNXT).
Benefits
- Compensation range: $16.35–$22.84 per hour, depending on experience, skills, and location.
- Fully remote position with long-term stability at an established nonprofit health plan.
- Comprehensive benefits package including medical, dental, vision, and pharmacy coverage.
- 403(b) savings plan with employer match and potential merit increases.
- Flexible Spending Accounts, paid time off, and career advancement opportunities.
- Resources to support employee and family well-being, plus a strong focus on diversity and inclusion.
Remote-friendly claims roles at reputable nonprofit health plans don’t stay on the market long.
If you’ve got claims experience and want a stable, fully remote position with real benefits, this is a solid move.
Happy Hunting,
~Two Chicks…