Benefits and Coding Administrator
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Job Location:
Somerville, NJ - USA
Monthly Salary:
$ 62400 - 90750
Posted on:
11 hours ago
Vacancies:
1 Vacancy
Job Summary
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
This role supports the accurate and effective implementation of benefits across all products. Its primarily responsible for benefit configuration and ensuring the configuration aligns with business requirements. Acting as a subject matter expert the incumbent will work on projects committees and workgroups to contribute to business discussions and developments.Essential Functions
-Evaluate benefit configuration in collaboration with IT Configuration and Claims staff ensuring that benefit configuration aligns with the approved business requirements and plan materials.
-Contribute to business discussions regarding benefit coverage and configuration drawing on claims experience knowledge of regulatory requirements industry standards regarding coding and billing and payer benchmarking for ad hoc and system-wide decisions.
-Represent Benefits Administration as a subject matter expert on corporate projects committees or workgroups.
-Provide technical business summaries on selected benefit topics in support of work required to develop and maintain benefits as required for specific program and plan requirements.
-Provide research and benchmarking on services and items represented by new codes as released quarterly leading the code load process including the presentation at the Benefit & Coding Committee and business requirements submission to IT Configuration.
-Contribute to benefit property development or modification in the integrated care administrative transaction system by coordinating business requirements with configuration requirements.
Qualifications
Education
- Associates degree required
Experience
- At least 3-5 years of experience in a related role required
- At least 3-5 years of experience in valuing the impact of benefit coverage decisions with the support of analytics required
Knowledge Skills and Abilities
- Strong knowledge of ICD-10 CPT and HCPCS coding systems as well as insurance verification and authorization processes.
- Familiarity with healthcare revenue cycle management including claims processing denial management and reimbursement methodologies.
- Excellent analytical organizational and problem-solving skills with a strong attention to detail.
- Effective communication and interpersonal skills with the ability to work collaboratively with various teams.
- Ability to stay current with changes in coding standards payer requirements and healthcare regulations.
Additional Job Details (if applicable)
Working Conditions
- This is a remote role that can be done from most US states
- This role is 40 hours/week with five 8-hour days with a typical schedule of 8:30 am to 4:30 pm
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$62400.00 - $90750.40/AnnualGrade
6EEO Statement:
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.
Required Experience:
Unclear Seniority
Key Skills
- Sales Experience
- Microsoft Office
- Customer Service
- Communication skills
- Microsoft Outlook
- Microsoft Word
- Business Management
- Benefits Administration
- Microsoft Excel
- Insurance Sales
- Customer relationship management
- Human Resources
About Company
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.
