Third Party Liability Representative

Mass General Brigham•Somerville, MA

1d•Remote

About The Position

The Third-Party Representative investigates potential recoveries for third-party liabilities using phone calls, questionnaires, claims, provider inquiries, ISO net, and other methods. The role manages communications with internal and external parties and conducts research to validate subrogation. It deals directly with attorneys, providers, members, third-party credit balance vendors, and other insurers. This full-time remote position works Monday through Friday, 8:00 AM–4:30 PM ET, for 40 scheduled hours per week. Remote work is available from approved U.S. locations, subject to organizational requirements. Employees must maintain a stable internet connection and a secure, private, quiet workspace suitable for handling confidential and protected health information; workspace requirements may be verified under organizational policy.

Requirements

High school diploma or equivalent.
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.

Nice To Haves

Associate’s degree.
At least 1–2 years of experience in healthcare billing, claims management, or third-party liability.

Responsibilities

Identify recovery opportunities within the coordination of benefits and third-party liabilities department.
Follow state statutes and regulations for medical liens, including completing lien and updated-lien requests from attorneys and negotiating lien settlements according to guidelines.
Research and process PIP and workers’ compensation claims.
Process third-party liability payments according to desktop procedures, contractual requirements, and regulatory requirements.
Verify patient information and coverage details, and coordinate benefits among primary health insurance, third-party payers, and government programs.
Contact or respond to members, providers, attorneys, and auto insurance companies to gather motor vehicle accident and workers’ compensation information.
Serve as the liaison for internal and external third-party liability inquiries and issues.
Respond to provider, member, and internal inquiries related to third-party liability cases.