Remote Claims Resolution Lead

Mass General Brigham Health Plan Holding Company, Inc.; Somerville (MA); Remote; USD 80,000 - 116,000; Full time

Job summary

Mass General Brigham Health Plan Holding Company, Inc. is seeking a Claims Resolution Supervisor to oversee the team responsible for reviewing provider requests, claims, and projects. The role emphasizes timely, accurate processing and consistent procedures across the operation.

Applicants should have 3–5 years in healthcare claims management, 1–2 years in supervision, and strong knowledge of billing regulations. Remote work from approved U.S. locations is available with standard daytime hours.

Qualifications

• Associate degree required; relevant experience may count in lieu.
• 3–5 years in healthcare claims management or billing.
• 1–2 years of supervisory or leadership experience preferred.
• Strong knowledge of healthcare billing, coding, and claims regulations.
• Excellent communication and collaboration across departments.

Responsibilities

• Supervise daily operations of the claims resolution team.
• Manage inventory of provider review requests and claims projects.
• Prioritize and distribute work based on deadlines and capacity.
• Oversee review of finalized claims for reconsideration.
• Develop and maintain procedures for consistent reviews.
• Prepare reports on inventory, turnaround times, and productivity.

Skills

Healthcare claims management

Billing regulations

Data analysis

Leadership

Communication

Attention to detail

Cross-department collaboration

Education

Associate degree in healthcare administration or related field

Job description

Mass General Brigham Health Plan Holding Company, Inc. is seeking a Claims Resolution Supervisor to oversee the team responsible for reviewing provider requests, claims, and projects. The role emphasizes timely, accurate processing and consistent procedures across the operation.

Applicants should have 3–5 years in healthcare claims management, 1–2 years in supervision, and strong knowledge of billing regulations. Remote work from approved U.S. locations is available with standard daytime hours.