Third Party Liability Representative
About The Position
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. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary The Third-Party Representative will be responsible for investigating potential recoveries for third party liabilities through phone calls, questionnaires, claims, provider inquiries, ISO net, and other methods as required. This person will also be responsible for management of communications with internal and external parties, and high-level research work related to validation of subrogation. Deals directly with attorneys, providers, members, third party credit balance vendors and other insurers.
Requirements
- High School Diploma or Equivalent required and Associate's Degree preferred
- At least 1-2 years of experience in healthcare billing, claims management, or third-party liability preferred
- Knowledge of healthcare billing practices, insurance coordination, and claims processing.
- Strong understanding of third-party liability regulations and claims processes.
- Excellent communication and customer service skills.
- Ability to handle sensitive information with discretion and confidentiality.
- Strong problem-solving and analytical abilities.
- Excellent organizational and multitasking skills with attention to detail and accuracy.
- Clear communication and interpersonal skills.
Responsibilities
- Responsible for identifying recovery opportunities within the coordination of benefits/third party liabilities department.
- Adhere to state statutes and regulations regarding medical liens including completing requests for liens/updated liens from attorneys as well as negotiating lien settlements with attorneys according to guidelines.
- Research and process PIP/Worker’s Compensation claims. Process TPL payments according to desktop procedures, contractual requirements, and other regulatory requirements.
- Verify patient information and coverage details, and coordinate benefits between primary health insurance, third-party payers, and government programs.
- Responsible for phone calls to or from members, providers, attorneys, and other auto insurance companies to gather MVA and Workers Comp information.
- Act as liaison for all TPL-related inquiries and issues both internal and external to the organization. Respond to providers, members and internal inquiries related to TPL cases.
- Responsible for phone calls to or from members, providers, attorneys, and other auto insurance companies to gather MVA and Workers Comp information.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
