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Third Party Reviewer

Third Party Reviewer

- (3247039)


As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We’re focused on a people-first culture for our system’s patients and our professional family. That’s why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees’ personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development—and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.


General Overview

The Third-Party Reviewer functions under the general supervision of the Specialty Billing Department Supervisor/Manager. This position is responsible for the review, follow-up and collection/resolution for all Third Party payors for Centers of Excellence and Hospice in the EPIC systems.


Principal Duties and Responsibilities
  • Review assigned accounts by ensuring timely resolution of accounts.

  • Create updates and document information relating to the financial status of accounts in the hospital billing systems.

  • Contact patients and/or other third-party representatives to secure additional information pertaining to reimbursement of accounts.

  • Process rejected/adjusted claims through various payer websites.

  • Communicates effectively with other MGB employees throughout the system.

  • Performs all other duties and assignments as requested.

Qualifications

  • Minimum of three years experience as a patient account representative in a hospital or medical office setting. High school diploma.

  • Excellent interpersonal skills and strong team player. Knowledge of third-party payer contracting language, terms and medical terminology.
  • Competency with Microsoft Word and Excel.


EEO Statement


Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. 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 the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.


Primary Location MA-Somerville-MGB Assembly Row
Work Locations MGB Assembly Row 399 Revolution Drive Somerville 02145
Job Auditing/Compliance
Organization Mass General Brigham
Schedule Full-time
Standard Hours 40
Shift Day Job
Employee Status Regular
Recruiting Department MGB Central Billing Office
Job Posting Jun 5, 2023

Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, to teaching and research, and to taking a leadership role as an integrated health care system. We recognize that increasing value and continuou...

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DATE POSTED
June 9, 2023

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