Supervisor, Commercial Claims Reviewer

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, United States
Base: $79,560.00 - $115,720.80/annual; bonus/equit...
Fully remote
Claims quality and payment accuracy
Denial trend analysis
High-dollar claim oversight
The Supervisor, Commercial Claims Review is responsible for leading a high-performing team focused on Commercial claims quality, payment accuracy, and adjudication integrity

Job Summary

  • The Supervisor, Commercial Claims Review is responsible for leading a high-performing team focused on Commercial claims quality, payment accuracy, and adjudication integrity.
  • This role oversees daily inventory management while driving continuous improvement through denial trend analysis, high-dollar claim oversight, and proactive identification of adjudication risks.
  • Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.

Matching Summary

The Supervisor, Commercial Claims Review is responsible for leading a high-performing team focused on Commercial claims quality, payment accuracy, and adjudication integrity.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • Claims quality and payment accuracy
  • Denial trend analysis
  • High-dollar claim oversight
  • Adjudication risk identification
  • Cross-functional partnership

Nice-to-have

  • Continuous improvement focus
  • Team professional growth support
  • Groundbreaking medical discoveries

Key Requirements

  • 3-5 years healthcare claims review experience
  • 1-2 years leadership experience
  • Bachelor's degree or equivalent experience
  • Certified Professional Coder preferred
  • Pharmacy Tech License preferred

Work Rights

Not specified

Tailored Resume

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