Billing Managed Care Coordinator

Site : The Brigham and Women's Hospital, 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

Responsible for obtaining appropriate insurance authorizations and referrals for all patient visits and procedures as well as working closely

with clinical and administrative staff and patients to answer billing and health insurance questions. Responsible for understanding medical

policies regarding procedural codes and maintaining records of policy changes. Assists the Billing Manager to ensure appropriate prior

authorization is in place prior to services being rendered, and smooth claim processing occurs post service.-Trains and mentors patient access staff, as well as provides input to managers regarding staff performance.

• Obtains insurance approval prior to initiation of patient services.
• Responsible for ensuring insurance referrals are received.
• Ensure accurate and timely billing and reimbursement from managed care organizations.
• Review and process managed care contracts and agreements.
• Manage and monitor billing and collections activities.
• Maintain up-to-date records of all managed care billing activities.

Qualifications

Education

High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred

Can this role accept experience in lieu of a degree?

No

Licenses and Credentials

Experience

Billing Experience 2-3 years preferred

Knowledge, Skills and Abilities

Additional Job Details (if applicable)

Physical Requirements

Remote Type

Remote

Work Location

60 Fenwood Road

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$21.78 - $31.08 / Hourly

Grade

4At 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. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement :

The Brigham and Women's Hospital, 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.