Supervisor Claims Resolution

8925 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 supervisor to lead the daily operations of the claims resolution team. You will assign work, coach staff, and monitor performance to ensure timely resolutions.

The role requires 3–5 years in healthcare claims management or billing with 1–2 years of supervisory experience; strong knowledge of billing regulations and internal processes is essential.

Qualifications

• Strong knowledge of healthcare billing, coding, and claims regulations.
• Ability to analyze finalized claims, identify trends in review requests, and resolve issues accurately.
• Strong leadership skills to assign work, coach staff, and monitor performance.

Responsibilities

• Supervises the daily operations of the claims resolution team, including work assignments, coaching, and performance management.
• Manages the inventory of provider review requests and claims projects, monitoring volume and aging.
• Prioritizes and distributes work based on deadlines, complexity, staff capacity, and needs.
• Oversees the review of finalized claims submitted for reconsideration through provider forms, calls, and other channels.
• Identifies trends in review requests and outcomes; escalates issues and recommends corrective actions.
• Coordinates with payers and internal departments to research claim issues and reach resolutions.
• Develops and maintains procedures supporting consistent reviews, documentation, and inventory management.
• Ensures the team’s work complies with applicable federal and state requirements and policies.
• Prepares reports on inventory, turnaround times, staff productivity, and resolution outcomes.

Skills

Healthcare claims management

Billing

Supervisory/leadership

Data analysis

Education

Associate’s degree

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc. 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

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Essential Functions

• Supervises the daily operations of the claims resolution team, including work assignments, training, coaching, and performance management.
• Manages the inventory of provider review requests and claims projects, monitoring volume, aging, and completion to ensure timely resolution.
• Prioritizes and distributes work based on deadlines, complexity, staff capacity, and operational needs.
• Oversees the review of finalized claims submitted for reconsideration through provider forms, phone calls, and other channels.
• Identifies trends in review requests, claim outcomes, and inventory; escalates recurring issues and recommends corrective actions.
• Coordinates with payers and internal departments as needed to research claim issues and reach accurate resolutions.
• Develops and maintains procedures that support consistent reviews, clear documentation, and efficient inventory management.
• Ensures the team’s work complies with applicable federal and state requirements and organizational policies.
• Prepares reports on inventory, turnaround times, staff productivity, and resolution outcomes, and identifies opportunities for improvement.

Education

Associate’s degree required. Relevant experience may be considered in lieu of a degree.

Experience

Three to five years of experience in healthcare claims management or billing required. One to two years of supervisory or leadership experience preferred.

Knowledge, Skills, and Abilities

Strong knowledge of healthcare billing, coding, and claims regulations. Ability to analyze finalized claims, identify trends in review requests, and resolve claim issues accurately. Strong leadership skills, including the ability to assign work, coach staff, and monitor team performance. Ability to manage a varied inventory of provider review requests and claims projects, set priorities, and meet deadlines. Clear communication skills for working with providers, payers, staff, and internal departments. Strong attention to detail, organization, and problem-solving skills. Ability to collaborate across departments to improve claim review processes and resolution outcomes.

Additional Job Details (if applicable)

Working Conditions This is a full-time role with a Monday through Friday schedule, generally 8:30-5:00 PM Eastern Time

This position is eligible for remote work from approved U.S. locations, subject to organizational requirements. Remote employees must maintain a stable internet connection and a secure, private, quiet workspace appropriate for handling confidential and protected health information. Remote workspace requirements, including privacy and security standards, may be verified in accordance with organizational policy Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $79,560.00 - $115,720.80/Annual Grade 7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

EEO Statement

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Combat disease. Hold a hand. Help people. Impact the world. Mass General Brigham is a passionate, welcoming community where minds meet caring hearts. Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Are you ready? Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.