Massachusetts General Hospital-posted 9 months ago
Full-time • Mid Level
Somerville, MA
Hospitals

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. The Benefits & Coding Supervisor acts as a subject matter expert working closely with the Manager of Benefits Administration overseeing different work and projects as the business need requires. The Supervisor works with the Benefits Administration team members to guide and support to ensure the accurate and effective implementation of coverage and cost sharing for all medical benefits across all products. This position is responsible for various functions including leading audits, daily meetings with the team to resolve benefit inquiries, and managing various libraries and systems related to benefits administration.

  • Lead audits and daily meetings with the team to resolve benefit inquiries.
  • Oversee the implementation of coverage and cost sharing for all medical benefits across all products.
  • Manage QNXT claims processing system business requirements for configuration.
  • Maintain Knowledge Center II (KCII) and Code Checker.
  • Collaborate with other business areas and attend Committee meetings as needed.
  • Manage Benefit Inquiry Library and BA IT Configuration Library as needed.
  • Associate's Degree in a related field of study required.
  • At least 3-5 years of experience in a related role required.
  • At least 3-5 years of experience in valuing the impact of benefit coverage decisions required.
  • Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
  • Familiarity with healthcare revenue cycle management, including claims processing, denial management, and reimbursement methodologies.
  • Excellent analytical, organizational, and problem-solving skills.
  • Effective communication and interpersonal skills.
  • Experience with analytics in support of benefit coverage decisions.
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