Claims Team Lead
13 hours ago
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
- 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
- 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
This is a hybrid role requiring an onsite presence to the Somerville office 1x/month.
Equal Employment OpportunityMass General Brigham is an Equal Opportunity Employer. We are committed to diversity, equity, and inclusion in the workplace.
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