Mass General Brigham Health Plan is seeking a Commercial Claims Operations Manager in Somerville, MA, responsible for overseeing efficient claims processing and team performance. The ideal candidate should have extensive claims management experience, strong leadership skills, and technological proficiency, with a focus on optimizing reimbursement processes
Job Summary
The Claims Operations Manager is responsible for managing commercial claims operations to ensure efficient and accurate processing of claims while supporting revenue cycle goals.
This role requires applying expert knowledge of payer-side adjudication rules, including MassHealth billing requirements and CMS regulations.
Candidates will lead, coach, and develop a team of Review Specialists and Resolution Coordinators to meet quality, time, and accuracy metrics.
Matching Summary
Match Score: 85
Mass General Brigham Health Plan is seeking a Commercial Claims Operations Manager in Somerville, MA, responsible for overseeing efficient claims processing and team performance. The ideal candidate should have extensive claims management experience, strong leadership skills, and technological proficiency, with a focus on optimizing reimbursement processes.
Salary
Base: $99,465.60 - $141,804.00/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement opportunities, differentials, premiums, and bonuses