Claims Review Specialist, Medicare Advantage
Mass General Brigham Health Plan•Boston, MA
404d•Remote
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About The Position
The Claims Review Specialist for Medicare Advantage at Mass General Brigham Health Plan is responsible for processing Medicare Advantage claims that do not auto adjudicate. This role involves adhering to the company's administrative policies, procedures, and clinical guidelines to ensure accurate and timely claims processing. The specialist will navigate multiple systems to verify information, communicate with external departments to resolve issues, and maintain performance goals related to productivity and accuracy.
