Claims Team Lead

13 hours ago


Somerville, Massachusetts, United States Mass General Brigham Health Plan Full time
Job Summary

We are seeking a highly skilled Claims Team Lead to join our team at Mass General Brigham Health Plan. As a Claims Team Lead, you will be responsible for researching and resolving disputes for providers, members, and internal customers, as well as coaching and mentoring claims resolution coordinators.

Key Responsibilities
  • Manage and distribute work as designated
  • Run and analyze reports
  • Review aging and inventory levels
  • Hold self and others accountable to meet commitments
  • Assist in testing new processes, system updates, and upgrades
  • Identify and provide claim scenarios for testing when needed
  • Assist in the development, implementation, and delivery of training
  • Functions as coach, mentor, and role model to staff
  • Establish and maintain effective customer relationships with internal stakeholders
  • Serve as liaison with other departments
  • Serve on Desktop committee for the creation, updating, and approval of desktop procedures
  • Act as subject matter expert on desktop procedures
  • Identify opportunities for process improvement and make recommendations
  • Perform special projects as needed
  • Review, research, and resolve the more difficult claims, call tracking, and correspondence by navigating multiple systems and platforms and accurately capturing the data/information necessary for processing
Requirements
  • Bachelor degree or the equivalent combination of training and experience
  • 5+ years of healthcare claims processing experience
  • Strong leadership skills
  • Organized with the ability to prioritize and multi-task
  • Excellent verbal and written communication skills
  • Highly motivated
  • Ability to work independently
  • Strong ability to hold information confidential
  • Excellent collaboration skills
  • Excellent customer service skills
  • Demonstrate Mass General Brigham Health Plan Core Values of Accountability, Service Excellence, Quality Care, Diversity, and forging strong Relationships
Preferred Qualifications
  • Knowledge of ICD-10, HCPCS, CPT-4, and Revenue Codes
  • Knowledge of medical terminology
  • Knowledge of claim forms (professional and facility)
  • Knowledge of Home Infusion Claim Processing
  • Knowledge of paper vs. electronic filing and medical billing guidelines
  • Completion of coding classes from certified medical billing school
  • Knowledge of Microsoft Office
  • Strong Excel skills
Work Environment

This is a hybrid role requiring an onsite presence to the Somerville office 1x/month.

Equal Employment Opportunity

Mass General Brigham is an Equal Opportunity Employer. We are committed to diversity, equity, and inclusion in the workplace.


  • Claims Team Lead

    2 weeks ago


    Somerville, Massachusetts, United States Mass General Brigham Full time

    Job Title: Claims Team LeadMass General Brigham Health Plan is a leading healthcare organization that offers innovative solutions to its members. As a Claims Team Lead, you will play a crucial role in resolving disputes and ensuring seamless care and coverage for our members.Key Responsibilities:Research and resolve disputes for providers, members, and...

  • Claims Team Lead

    1 week ago


    Somerville, Massachusetts, United States Mass General Brigham Health Plan Full time

    Job Title: Claims Team LeadMass General Brigham Health Plan is a leading healthcare organization that offers innovative solutions to its members. As a Claims Team Lead, you will play a crucial role in resolving disputes and ensuring seamless care and coverage for our members.Key Responsibilities:Research and resolve disputes for providers, members, and...

  • Claims Team Lead

    4 weeks ago


    Somerville, Massachusetts, United States Mass General Brigham Health Plan Full time

    Job SummaryMass General Brigham Health Plan is seeking a highly skilled Claims Team Lead to join our team. As a Claims Team Lead, you will be responsible for researching and resolving disputes for providers, members, and internal customers, as well as coaching and mentoring claims resolution coordinators.Key ResponsibilitiesManage and distribute work as...


  • Somerville, Massachusetts, United States Cataldo Ambulance Full time

    About Cataldo Ambulance ServiceCataldo Ambulance Service, Inc. has been a leader in providing routine and emergency medical services since 1977. Our commitment to innovation and community care has enabled us to expand our services and introduce new programs to meet the evolving needs of our patients and the community.Our MissionWe strive to provide the...

  • Nurse Team Lead

    21 hours ago


    Somerville, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse Team LeadMass General Brigham is seeking a skilled Registered Nurse (RN) to lead our Progressive Care Unit (PCU) team. As a key member of our nursing staff, you will be responsible for providing exceptional patient care and leading a team of dedicated professionals.Job Summary: The Registered Nurse Team Lead will be responsible...

  • Cashier Team Lead

    2 weeks ago


    Somerville, Massachusetts, United States Ulta Beauty Full time

    Lead Cashier at Ulta BeautyWe're seeking a skilled and customer-focused Lead Cashier to join our team at Ulta Beauty Hickory Point Mall. As a key member of our sales floor team, you'll be responsible for:Key Responsibilities:Promptly acknowledge and warmly greet each guest entering the storeComplete select register open and close functionsCourteously handle...

  • Sales Team Lead

    2 weeks ago


    Somerville, Massachusetts, United States HART GROUP Full time

    Lead Business Growth with HART GROUPHART GROUP is seeking a highly motivated and results-driven Community Salesperson to join our team. As a key member of our organization, you will be responsible for driving business growth, developing relationships, and leading a small team to achieve sales targets.Key Responsibilities:Service existing client base and...


  • Somerville, Massachusetts, United States Atrius Health Full time

    Job SummaryAtrius Health, a leading healthcare organization, seeks a highly skilled Pharmacy Department Team Lead to join our team. As a key member of our pharmacy team, you will play a critical role in ensuring the smooth operation of our pharmacy department.ResponsibilitiesCoordinate daily support operations of the Pharmacy DepartmentSupervise and lead...


  • Somerville, Massachusetts, United States Whole Foods Market Full time

    Job SummaryWe are seeking a highly motivated and experienced Prepared Foods Team Lead to join our team at Whole Foods Market. As a key member of our prepared foods department, you will be responsible for leading a team of associates to deliver exceptional customer service and drive sales growth.Key ResponsibilitiesLead and develop a high-performing team of...


  • Somerville, Massachusetts, United States ActBlue Full time

    About the RoleActBlue is seeking a highly skilled and experienced Admin Support Manager to join our team. As a key member of our Admin Support Team, you will play a critical role in supporting your direct reports in meeting their individual business and development goals, as well as the team meeting their team-level goals.Key ResponsibilitiesManage a team of...


  • Somerville, Massachusetts, United States Whole Foods Market Full time

    Job SummaryWe are seeking a highly skilled and experienced Customer Service Team Lead to join our team at Whole Foods Market. As a key member of our Store Support Team, you will be responsible for ensuring the smooth operation of our store, providing exceptional customer service, and leading a team of Store Support Team Members.Key ResponsibilitiesTeam...


  • Somerville, Massachusetts, United States Atrius Health Full time

    Job SummaryAtrius Health, a leading healthcare organization, seeks a highly skilled Pharmacy Department Team Lead to coordinate daily support operations and supervise pharmacy support staff. This role requires strong leadership potential, in-depth knowledge of pharmacy operations, and excellent communication skills.ResponsibilitiesCoordinate daily support...


  • Somerville, Massachusetts, United States RWJBarnabas Health Full time

    Job Title: Patient Access Team LeadJoin RWJBarnabas Health as a Patient Access Team Lead and play a key role in providing excellent customer service while ensuring timely throughput and capturing all necessary data timely.Job Summary:The Patient Access Team Lead is responsible for greeting all patients in a timely and friendly manner, obtaining and...

  • Sales Team Lead

    3 weeks ago


    Somerville, Massachusetts, United States Warby Parker Full time

    About the Role:Warby Parker is seeking a highly motivated and experienced Sales Supervisor to join our team at Assembly Row. As a Sales Supervisor, you will play a key role in creating exceptional customer experiences and driving sales growth.Key Responsibilities:Communicate Warby Parker's values and brand philosophy to customers, promoting a positive and...


  • Somerville, Massachusetts, United States Diedre Moire Corp. Full time

    Medical Malpractice Underwriting OpportunityDiedre Moire Corp. is seeking an experienced Underwriter to join our team in Somerville, MA. As an Underwriter for Medical Malpractice Claims, you will be responsible for evaluating and managing risk for physicians, surgeons, and other medical professionals.Key Responsibilities:Evaluate and underwrite medical...


  • Somerville, Massachusetts, United States Mass General Brigham Full time

    Job SummaryWe are seeking a highly skilled Benefits & Coding Administrator to join our team at Mass General Brigham Health Plan. This role will play a critical part in supporting the accurate and effective implementation of benefits across all products.Key ResponsibilitiesEvaluate benefit configuration in collaboration with IT Configuration and Claims staff...


  • Somerville, Massachusetts, United States Mass General Brigham Full time

    Job SummaryWe are seeking a highly skilled Medical Director to lead our Medicare and Special Investigations Unit. As a key member of our team, you will be responsible for providing clinical oversight and leadership for our Medicare Advantage line of business. This is a hybrid role with occasional onsite team meetings in Somerville, MA.Key...


  • Somerville, Massachusetts, United States Velocity Search Group Full time

    About the RoleWe are seeking a highly skilled and experienced Architect Project Lead to join our team at Velocity Search Group. As a key member of our team, you will be responsible for leading projects from conception to completion, ensuring that they are delivered on time, within budget, and to the highest quality standards.Key ResponsibilitiesProject...

  • Medical Lead RN

    1 week ago


    Somerville, Massachusetts, United States Mass General Brigham Full time

    Job Title: Registered Nurse Medical LeadMass General Brigham is seeking a highly skilled Registered Nurse (RN) to fill the role of Medical Lead in our Emergency Department. As a key member of our team, you will be responsible for providing leadership and guidance to our nursing staff, ensuring the delivery of high-quality patient care and promoting a...


  • Somerville, Massachusetts, United States Deep Health Somerville Full time

    Job Title: Clinical Product ManagerAt Deep Health Somerville, we are seeking a highly skilled Clinical Product Manager to join our team. As a Clinical Product Manager, you will be responsible for overseeing all activities related to researching, designing, and marketing our products.Key Responsibilities:Manage clinical product positioning and messaging...