Massachusetts General Hospital
Job Summary
The Appeals Assistant is vital to the team and supports the appeals and claims resolution process, ensuring timely submission and follow-up on appeals for DSNP and Medicare Advantage lines of business at Mass General Brigham Health Plan. The role involves gathering documentation, tracking case statuses, and coordinating communication between departments to ensure accurate handling of claims.
What You'll Do
Prepares and submits appeal documents and claims-related materials.
Maintains organized records of all appeals and claim-related communications and case statuses.
Coordinates with billing and claims teams to ensure proper documentation for appeals.
Assists with follow-up on pending appeals and communicates status updates to relevant parties.
Supports the preparation of reports on appeals activity, trends, and outcomes.
Handles correspondence related to appeals, including letters, forms, and supporting documentation.
Monitors appeal deadlines and ensures timely submission and follow-up.
Provides administrative support to the billing/claims team and other departments as needed.
Qualifications Education High School Diploma or Equivalent required.
Experience
At least 1-2 years of Administrative experience required.
At least 1-2 years of experience in a healthcare billing or claims setting preferred.
Experience with Medicare Advantage and DSNP claims highly preferred.
Skills For Success
Proficient organizational and time-management skills.
Effective written and verbal communication abilities.
Proficient in Microsoft Office and other billing software.
Attention to detail and accuracy in document preparation.
Ability to handle multiple tasks and work efficiently in a fast-paced environment.
Additional Job Details (if applicable) Working Model Requirements
This is a remote role; M-F, schedule ranges from 8 AM - 5:30 PM EST.
A stable, secure, quiet, compliant workstation is required within the US.
Remote Type Remote
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $19.42 - $27.74/Hourly
Grade 3
Base Pay Estimate 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 package. In 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.
EEO Statement 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 Veteran's 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 (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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What You'll Do
Prepares and submits appeal documents and claims-related materials.
Maintains organized records of all appeals and claim-related communications and case statuses.
Coordinates with billing and claims teams to ensure proper documentation for appeals.
Assists with follow-up on pending appeals and communicates status updates to relevant parties.
Supports the preparation of reports on appeals activity, trends, and outcomes.
Handles correspondence related to appeals, including letters, forms, and supporting documentation.
Monitors appeal deadlines and ensures timely submission and follow-up.
Provides administrative support to the billing/claims team and other departments as needed.
Qualifications Education High School Diploma or Equivalent required.
Experience
At least 1-2 years of Administrative experience required.
At least 1-2 years of experience in a healthcare billing or claims setting preferred.
Experience with Medicare Advantage and DSNP claims highly preferred.
Skills For Success
Proficient organizational and time-management skills.
Effective written and verbal communication abilities.
Proficient in Microsoft Office and other billing software.
Attention to detail and accuracy in document preparation.
Ability to handle multiple tasks and work efficiently in a fast-paced environment.
Additional Job Details (if applicable) Working Model Requirements
This is a remote role; M-F, schedule ranges from 8 AM - 5:30 PM EST.
A stable, secure, quiet, compliant workstation is required within the US.
Remote Type Remote
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $19.42 - $27.74/Hourly
Grade 3
Base Pay Estimate 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 package. In 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.
EEO Statement 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 Veteran's 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 (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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