Claims Production Specialist

Baystate Health ’s Health New England is seeking a detail-oriented Claims Production Specialist to join the Claims team in Springfield, MA. RESPONSIBILITES The Claims Production Specialist supports accurate and timely processing, adjustment, recovery, and finalization of medical claims. As part of the Claims Production Team, you’ll help ensure claims are processed in accordance with established policies, quality standards, and regulatory requirements while contributing to efficient operations and positive provider experiences. Drive Claims Accuracy: Review and finalize medical claims, adjustments, and retractions in accordance with established policies and procedures. Solve Problems: Investigate pending claims, research discrepancies, and coordinate with claims adjudication partners and vendors to resolve issues. Support Quality and Performance: Meet productivity and accuracy goals while helping the team deliver consistent, high-quality results. Identify Opportunities for Improvement: Recognize unusual claims trends, processing variations, and potential issues, escalating findings to senior team members. Collaborate Across Teams: Partner with Senior Claims Production Specialists, Finance, ASO, and external vendors to resolve claims issues and process provider refunds. Deliver Responsive Service: Manage incoming claims inquiries and requests accurately and within established timelines. Protect Data and Compliance: Maintain confidentiality, follow regulatory requirements, and u