Third Party Liability Representative

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

The Third-Party Representative will be responsible for investigating potential recoveries for third party liabilities through phone calls questionnaires claims provider inquiries ISO net and other methods as required. This person will also be responsible for management of communications with internal and external parties and high-level research work related to validation of subrogation. Deals directly with attorneys providers members third party credit balance vendors and other insurers.

Essential Functions
-Responsible for identifying recovery opportunities within the coordination of benefits/third party liabilities department.
-Adhere to state statutes and regulations regarding medical liens including completing requests for liens/updated liens from attorneys as well as negotiating lien settlements with attorneys according to guidelines.
-Research and process PIP/Workers Compensation claims. Process TPL payments according to desktop procedures contractual requirements and other regulatory requirements.
-Verify patient information and coverage details and coordinate benefits between primary health insurance third-party payers and government programs.
-Responsible for phone calls to or from members providers attorneys and other auto insurance companies to gather MVA and Workers Comp information.
-Act as liaison for all TPL-related inquiries and issues both internal and external to the organization. Respond to providers members and internal inquiries related to TPL cases.
-Responsible for phone calls to or from members providers attorneys and other auto insurance companies to gather MVA and Workers Comp information.

Education

• High School Diploma or Equivalent required and Associates Degree preferred

Experience

• At least 1-2 years of experience in healthcare billing claims management or third-party liability preferred

Knowledge Skills and Abilities

• Knowledge of healthcare billing practices insurance coordination and claims processing.
• Strong understanding of third-party liability regulations and claims processes.
• Excellent communication and customer service skills.
• Ability to handle sensitive information with discretion and confidentiality.
• Strong problem-solving and analytical abilities.
• Excellent organizational and multitasking skills with attention to detail and accuracy.
• Clear communication and interpersonal skills.

Working Conditions

• This is a remote role that can be done from most US states
• This is a full-time schedule with a Monday through Friday 8:00 AM - 4:30 PM EDT schedule

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$19.42 - $27.74/Hourly

Grade

3

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 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.

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 Veterans 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 .

Mass General Brigham Competency Framework