Manager, Recoveries

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 worlds 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.

Responsible for managing the Coordination of Benefits and Third Party Liability organizations. Oversee the process of recovering funds from other health insurance plans and liable third parties for claim-related expenses and ensuring compliance with relevant laws and regulations. Lead the identification of responsible parties evaluation of claims and manage the end-to-end recovery process often working with insurance companies attorneys and other stakeholders. This role also involves supervising staff developing and implementing strategies to optimize cost recovery and maintaining accurate records while ensuring that all recovery efforts are conducted in compliance with the organizations policies and regulatory requirements.

Essential Functions
-Oversee the Coordination of Benefits and Third Party Liability processes for recovering funds related to COB and TPL claims.
-Develop and implement strategies to maximize recovery rates and minimize revenue loss.
-Manage mentor and train the Recoveries Team to ensure efficient and effective handling of accounts.
-Conduct performance evaluations provide feedback and support professional development for team members.
-Review and analyze denied claims and billing issues to determine the root cause and appropriate course of action.

Education

• Bachelors Degree required; experience can be considered in lieu of a degree

Experience

• At least 5-7 years of experience in COB TPL and claims adjudication experience required
• At least 2-3 years of experience in a supervisory or leadership role required
• At least 2-3 years of experience within a health plan setting preferred

Knowledge Skills and Abilities

• Strong knowledge of health insurance claims coordination of benefits and third-party liability.
• Excellent leadership organizational and team management skills.
• Proficiency in using health plan software and tools.
• Strong analytical and problem-solving skills with attention to detail.
• Effective communication and interpersonal skills.

Hybrid

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$99465.60 - $144643.20/Annual

Grade

8

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 .