Supervisor, Medicaid 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
Medicaid claims processing experience
Aco claims adjudication knowledge
Claims denial trend analysis
Mass General Brigham Health Plan is seeking a Supervisor for their Medicaid Claims Review team, responsible for ensuring accurate healthcare claims processing and compliance. The ideal candidate should have a strong background in Medicaid/ACO claims processing, leadership experience, and a Certified Professional Coder designation

Job Summary

  • This role supervises a team of roughly 5 Medicaid Claims Reviewers responsible for ensuring accurate and timely healthcare claims processing.
  • The ideal candidate must have a strong background in Medicaid/ACO claims processing and be a Certified Coder capable of understanding complex claims edits.
  • Mass General Brigham offers competitive base pay ranging from $79,560.00 to $115,720.80 annually along with comprehensive benefits and career advancement opportunities.

Matching Summary

Match Score: 85

Mass General Brigham Health Plan is seeking a Supervisor for their Medicaid Claims Review team, responsible for ensuring accurate healthcare claims processing and compliance. The ideal candidate should have a strong background in Medicaid/ACO claims processing, leadership experience, and a Certified Professional Coder designation.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement, differentials, premiums, and bonuses

Skills & Requirements

Must-have

  • Medicaid claims processing experience
  • ACO claims adjudication knowledge
  • Claims denial trend analysis
  • Team supervision and mentoring
  • High-dollar claim review

Nice-to-have

  • Strong attention to detail
  • Excellent communication skills
  • Process improvement mindset
  • Collaborative team player

Key Requirements

  • Bachelor's degree or equivalent experience
  • Certified Professional Coder (CPC) license preferred
  • 3-5 years healthcare claims review experience
  • 1-2 years senior or leadership experience

Work Rights

Not specified

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