Mass General Brigham · 3 weeks ago
Benefits and Coding Administrator
United States
Full-time
Remote
Mid Level
$62K/yr - $91K/yr
3+ years expMass General Brigham is a not-for-profit organization committed to advancing patient care, research, and community service. The Benefits and Coding Administrator role is focused on supporting the implementation of benefits across all products, ensuring alignment with business requirements, and acting as a subject matter expert on various projects and committees.
Health CareHome Health CareMedical
Responsibilities
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
Qualification
Required
Associate's degree required
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
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
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
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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