- CVS Health (Boston, MA)
- …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role...claims systems (eg, Salesforce, Facets) in compliance with audit standards and MassHealth requirements. + Maintain awareness of… more
- Commonwealth Care Alliance (Boston, MA)
- …Experience (must have): * 5+ years in healthcare compliance, regulatory affairs, or claims audit . * Experience working with TPA partners (eg, Cognizant) and ... not be considered at this time._** Position Summary: Reporting to the Director, Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr.… more
- Boston Public Schools (Boston, MA)
- …school and program locations to ensure program meal accountability and operational quality at each location + Conducts an annual site operational performance and ... compliance audit of each assigned school kitchen or program location...are accurate and complete for timely submission of monthly claims . + Monitors supply and labor costs by management… more