Claims Review Specialist, Medicare Advantage — Mass General Brigham
Mass General Brigham
Pay$17.71-$25.28
LocationRemote - United States
Remote statusRemote
Phone levelLow phone
IndustryHealthcare / Health Insurance
OccupationClaims Review Specialist
Job functionMedicare Advantage Claims Adjudication
State restrictionsRemote from most U.S. states
Eligible countriesUnited States
RegionNorth America
Job Summary
Reviews Medicare Advantage claims requiring manual intervention, researches pricing, contracts, authorizations and benefits across multiple systems, adjudicates claims to pay, deny or pend, and resolves claim-processing errors.
Job Description
Reviews Medicare Advantage claims requiring manual intervention, researches pricing, contracts, authorizations and benefits across multiple systems, adjudicates claims to pay, deny or pend, and resolves claim-processing errors.
Additional Requirements & Compensation
Work authorizationNot specified
LanguageStrong written and verbal English communication
Time zone8:30 AM-5:00 PM Eastern Time
Additional Job Details
- Full-time, 40 hours per week. Typical schedule is 8:30 AM-5:00 PM ET. High school diploma/equivalent required
- associate degree preferred. Requires 1-2 years related healthcare experience
- 2-3 years health-insurance claims and Medicare claims experience are highly preferred. QNXT or similar systems such as Facets are preferred.
Posting Information
Posted date2026-09-20