Remote Medicare Advantage Claims Specialist

Mass General Brigham Health Plan is seeking a Medicare Advantage Claims Review Specialist to process and adjudicate complex Medicare claims when autoadjudication isn’t achieved. The role requires familiarity with QNXT or similar adjudication systems and strict adherence to policies and guidelines. The position is remote and involves reviewing claims, applying correct benefits, and collaborating with multiple departments to resolve issues while maintaining high accuracy and compliance standards. #J-18808-Ljbffr Mass General Brigham Health Plan, Inc.