Start a stable, full-time remote role supporting claims accuracy for a mission-driven health plan.
About WellSense Health Plan
WellSense is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire. For 25 years, we’ve delivered high-quality Medicaid, Medicare, and Individual/Family plans that support members no matter their circumstances. We’re dedicated to improving health equity and expanding access to care.
Schedule
• Full-time, remote
• Monday–Friday with occasional overtime during peak periods
• Reliable internet required
Responsibilities
• Review and process Medicaid claims using Coordination of Benefits (COB) rules
• Update and maintain member coverage information across claims systems
• Communicate with providers to resolve claim-related inquiries
• Follow federal and state COB guidelines for Commercial, Medicare, and Medicaid
• Navigate multiple systems to research, update, and verify claim details
• Complete other tasks as assigned
Requirements
• High School Diploma or GED required
• 2+ years of claims processing experience
• 2+ years of health insurance experience with working knowledge of industry terminology
• Proficiency with Microsoft Office and the ability to work across multiple systems
• Strong attention to detail and the ability to follow written instructions
• Clear, professional communication skills
• Understanding of COB rules (Commercial, Medicaid, Medicare)
Preferred Qualifications
• Consecutive 2-year work history
• Experience with Cognizant systems (Facets, QNXT)
Benefits
• Competitive salary range: $16.35–$22.84/hr
• Comprehensive medical, dental, vision, and pharmacy benefits
• 403(b) with company match
• Flexible Spending Accounts
• Paid Time Off and holidays
• Career advancement opportunities
• Employee wellbeing resources
• Full-time remote work
Happy Hunting,
~Two Chicks…