Mass General Brigham · 1 day ago
Supervisor, Medicaid Claims Reviewer
United States
Full-time
Remote
Mid, Senior Level
$78K/yr - $113K/yr
3+ years expMass General Brigham is a not-for-profit organization dedicated to advancing patient care, research, teaching, and community service. The Supervisor, Medicaid Claims Reviewer role involves overseeing a team of claims reviewers to ensure accurate and timely processing of healthcare claims while guiding and supporting the team in resolving complex claims issues and improving claims processing efficiency.
Health CareHome Health CareMedical
Responsibilities
Supervise and manage a team of claims reviewers to ensure accurate and timely healthcare claims processing
Oversee claims review and analysis to ensure compliance with healthcare regulations, payer requirements, and organizational policies
Resolve escalated or complex claims issues, ensuring appropriate adjudication and dispute resolution
Monitor team performance, provide feedback, and conduct regular evaluations to support professional growth
Implement and enforce policies and procedures to streamline the claims review process for greater accuracy and efficiency
Collaborate with billing, coding, and compliance teams to ensure adherence to regulatory and payer standards
Analyze claims data to identify trends, address issues, and recommend process improvements
Provide training, guidance, and ongoing education for new and existing team members on industry changes and standards
Performs other duties as assigned
Ensure that the medical claims include complete and accurate documentation supporting the services rendered, including physician notes, test results, and other relevant records
Analyze claim payment amounts and compare them to contracted rates, fee schedules, and industry benchmarks
Identify underpayments, overpayments, and potential billing errors
Conduct comprehensive audits of medical claims to verify compliance with billing regulations, payer policies, and internal policies and procedures
Stay updated on insurance company policies, billing guidelines, and reimbursement rules
Qualification
Required
Bachelor's degree required (experience can be considered in lieu of degree)
At least 3-5 years of experience in healthcare claims review or processing required
At least 1-2 years of experience in a senior or leadership role required
Strong knowledge of healthcare claims processes, coding (CPT, ICD-10), and payer regulations
Excellent leadership, communication, and problem-solving skills
Proficiency in claims processing software and healthcare management systems
Strong attention to detail and the ability to manage multiple tasks and priorities
Preferred
Certified Professional Coder (CPC) preferred
Benefits
Comprehensive benefits
Career advancement opportunities
Differentials
Premiums and bonuses as applicable
Recognition programs designed to celebrate your contributions and support your professional growth
Company
Mass General Brigham
Mass General Brigham specializes in providing medical treatments and health diagnostics services.
10001+ employees
H1B Sponsorship
Mass General Brigham has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (77)
2024 (61)
2023 (93)
2022 (70)
2021 (80)
2020 (29)
Funding
Current Stage
Late StageLeadership Team
E
Erin Flanigan
SVP, Human Resources, Community, Specialty Hospital Division
O’Neil A. Britton
Chief Integration Officer, Executive Vice President
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