Top 54 Claims coordinator Jobs in Somerville Ma

DSNP Claims Resolution Coordinator
Mass General Brigham Health Plan Holding Company, Inc. —Somerville, MA
- $19.81 - $28.30 an hour
- Full-time
- Remote
- HIPAA
- Research
- Mid-level
- Health insurance
- Opportunities for advancement
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5d
Billing Coordinator - Healthcare
Boston Health Care for the Homeless Program —Boston, MA
- $22.25 - $35.60 an hour
- Full-time
- Bilingual
- Microsoft Word
- Microsoft Excel
- Health insurance
- Dental insurance
Quick Apply
Appeals & Grievances Coordinator
Mass General Brigham Health Plan Holding Company, Inc. —Somerville, MA
- $30.60 - $44.51 an hour
- Full-time
- Remote
- Bilingual
- Writing skills
- Mid-level
- Health insurance
- Opportunities for advancement
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10h
Experienced Dental Patient Coordinator
Confidential —Revere, MA
- $26 - $35 an hour
- Full-time
- Dental office
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
16h
Patient Financial Services & Billing Coordinator
New England Women's Healthcare —Woburn, MA
- Full-time
- Background check
- Private practice
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
1d
Billing Coordinator
FECC Eye Care & Optical (Westford) —Westford, MA
- $20 - $24 an hour
- Full-time
- Private practice
- Mid-level
- Administrative experience
- Paid holidays
- Health insurance
Quick Apply
Client Coordinator
MES Solutions —Norwood, MA
- $17 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- 401(k)
- Paid time off
Quick Apply
6d
Dental Receptionist/ Orthodontic Treatment Coordinator
Boston Pediatric Dental Group —Cambridge, MA
- $25 - $30 an hour
- Full-time
- Bilingual
- Dental office
- Microsoft Excel
- Free parking
- Paid training
Quick Apply
14d
Patient Care Coordinator - onsite
Boston Medical Center —Boston, MA
- $22.84 - $31.97 an hour
- Full-time
- Surgery
- Word processing
- Writing skills
- Health insurance
- Dental insurance
Dental Patient Care Coordinator
Jeffrey A. Harrison, DMD ~ Metro West Dental —Wellesley Hills, MA
- $25 - $32 an hour
- Full-time
- Private practice
- Dental office
- Administrative experience
- Paid holidays
- Health insurance
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2d
Dental office Manager /Insurance Coordinator
Mass Perio & Dental Implant Center —Brookline, MA
- $30 - $40 an hour
- 8 hour shift
- Private practice
- Dental office
- Surgery
- Continuing education credits
- Employee discount
Quick Apply
9d
Appeals & Grievances Coordinator
Rxadvance Corporation —Southborough, MA
- $55,000 - $75,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
Quick Apply
Treatment Coordinator
Children and Family Dentistry —Brockton, MA
- Up to $28 an hour
- Full-time
- Dental office
- Office
- Administrative experience
Quick Apply
7d
George B. Cox Fellow Human Resources Coordinator (SY26-27)
Boston Public Schools —Boston, MA
- Up to $76,740 a year
- Full-time
- Background check
- Spanish
- Microsoft Outlook
Front Desk Receptionist/Insurance Coordinator
Mass Perio & Dental Implant Center —Brookline, MA
- $22 - $36 an hour
- Full-time
- Dental office
- HIPAA
- Administrative experience
- Paid training
- Continuing education credits
Quick Apply
9d
Accounting Coordinator of Payroll / RAO - 1.0 FTE
Wellesley Public Schools —Wellesley, MA
- $32.67 - $41.44 an hour
- Full-time
- Psychiatry
- Mid-level
- Analysis skills
- 403(b)
4d
Patient Care Coordinator
Vision Care Specialists —Southborough, MA
- $21.01 - $28.00 an hour
- Computer literacy
- High school diploma or GED
- Organizational skills
- Health savings account
- Paid holidays
Quick Apply
Accounts Receivable Coordinator
Bane Care Management, LLC —Beverly, MA
- $60,000 - $95,000 a year
- Full-time
- Skilled nursing facility
- Microsoft Outlook
- Mid-level
Quick Apply
Hospital Billing Coordinator
Deloitte —Boston, MA
- $50,000 - $60,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Bachelor's degree
Resident Relocation Coordinator - (Boston, MA)
Housing Opportunities Unlimited —Boston, MA
- $58,000 - $60,000 a year
- Full-time
- Spanish
- Customer service
- Ability to walk for extended periods
- Disability insurance
- Health insurance
Quick Apply

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DSNP Claims Resolution Coordinator

Mass General Brigham Health Plan Holding Company, Inc. -
Somerville, MA

Quick Apply

Job Details

Full-time
$19.81 - $28.30 an hour
5 days ago

Benefits

Health insurance
Opportunities for advancement

Qualifications

Customer communication

Full Job Description

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 world’s 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.

The DSNP Claims Resolution Coordinator is responsible for reviewing, researching, and resolving Dual Eligible Special Needs Plan (DSNP) claim inquiries, provider correspondence, and escalations received through Customer Service and internal business partners. This role determines whether claim adjustments are needed, applies Medicare and Medicaid benefit and payment guidelines, and ensures claims are processed accurately, timely, and in accordance with Mass General Brigham Health Plan policies, contractual requirements, and regulatory expectations. The coordinator uses independent judgment, strong analytical skills, and cross-functional collaboration to identify claim issues, support resolution, and help improve the member and provider experience.

Primary Responsibilities:

Review, research, and resolve assigned DSNP claim inquiries, provider correspondence, and escalations using QNXT and other internal systems.
Determine appropriate claim action, including payment, denial, adjustment, manual entry, or pending for additional review, in accordance with applicable Medicare and Medicaid guidelines.
Validate benefits, authorizations, pricing, fee schedules, contracts, Letters of Agreement, and member eligibility to support accurate and timely claim resolution.
Maintain accurate documentation in applicable tracking systems, including call tracking records, claim notes, reports, and reimbursement request records.
Communicate and collaborate with Customer Service, Provider Relations, Configuration, Pricing, Compliance, and other business partners to resolve claim issues and escalations.
Identify, research, and escalate system, configuration, pricing, benefit, or process issues timely and with clear supporting detail.
Apply current desktop procedures, benefit documents, claims policies, and training resources to ensure consistent and compliant claim handling.
Meet established productivity, quality, timeliness, and attendance expectations while supporting member and provider satisfaction.
Support assigned reports, member reimbursement requests, special projects, and other departmental responsibilities as needed.
Model accountability, collaboration, inclusion, and a people-first approach in daily work and cross-functional interactions.
Other duties as required.

Qualifications

Education:

Associate’s degree preferred.

Experience:

At least 2-3 years of healthcare claims experience required

Knowledge, Skills, and Abilities:

Knowledge of medical billing and coding principles, reimbursement methodologies, and insurance claim submission processes.
Knowledge of healthcare regulations and compliance requirements, including HIPAA guidelines.
Familiarity with Medicare, Medicaid, government programs, and applicable billing requirements.
Strong attention to detail and accuracy in claim submissions, research, documentation, and recordkeeping.
Excellent written and verbal communication skills to interact effectively with insurance companies, providers, members, patients, and colleagues.
Strong customer service orientation and ability to handle sensitive or difficult situations with empathy, professionalism, and sound judgment.

Additional Job Details (if applicable)

Working Conditions

This is a remote role that can be done from most US states
This is a full-time schedule (8-4:30 pm or 8:30-5:00 pm ET)
Remote workdays require a stable, secure, quiet, and compliant workspace

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$19.81 - $28.30/Hourly

Grade

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. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

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 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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Refine Your Search

claims coordinator jobs in somerville ma

DSNP Claims Resolution Coordinator

Billing Coordinator - Healthcare

Appeals & Grievances Coordinator

Experienced Dental Patient Coordinator

Patient Financial Services & Billing Coordinator

Billing Coordinator

Client Coordinator

Dental Receptionist/ Orthodontic Treatment Coordinator

Patient Care Coordinator - onsite

Dental Patient Care Coordinator

Dental office Manager /Insurance Coordinator

Appeals & Grievances Coordinator

Treatment Coordinator

George B. Cox Fellow Human Resources Coordinator (SY26-27)

Front Desk Receptionist/Insurance Coordinator

Accounting Coordinator of Payroll / RAO - 1.0 FTE

Patient Care Coordinator

Accounts Receivable Coordinator

Hospital Billing Coordinator

Resident Relocation Coordinator - (Boston, MA)

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