- Sedgwick (Boston, MA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- State of Massachusetts (Boston, MA)
- …within the Department of Family Medical Leave (DFML). The Claims Examiner/Job Service Representative I will review claims escalated by the Contact Center ... * Claims Examiner/Job Service Representative I| Department...remand to the appropriate internal department. 4. Collect and review available data to identify, prioritize, and resolve atypical… more
- Ryder System (Boston, MA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Zurich NA (Boston, MA)
- Claims Concierge Service Executive 127284 Zurich is looking to hire a ** Claims Concierge Service Executive** in our Claims Relationship Management team. This ... business units and functional groups to execute strategies that promote claims value-added services, drive profitable growth, and improve technical excellence,… more
- Cardinal Health (Boston, MA)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and interprets third party payments, adjustments, and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts, ... information that impacts the resolution of current or potential future claims . 3. Establishes relationships and maintains open communication with third party… more
- CVS Health (Boston, MA)
- …CVS Aetna has an opportunity available for a full time Customer Service Representative in the Behavioral Health team. This role provides advocate care to assist ... the member with a clear path to care, claims understanding and resolution and educates the member with...educates the member with online resources. The Customer Service Representative guides the member through their members plan of… more
- Highmark Health (Boston, MA)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Takeda Pharmaceuticals (Lexington, MA)
- …groups and support of US Medical colleagues. * Serve as Medical Information and Review subject matter expert representative at US Medical Unit meetings. * ... Takeda as a Senior Manager, US Medical Information and Review where you will deliver high-quality, balanced and timely...approval of clinical data on file to support promotional claims . * Drive innovation by integrating AI technologies to… more
- Ryder System (Boston, MA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- State of Massachusetts (Boston, MA)
- …work, available for work and looking for a job. The Job Service Representative I performs customer service and issue resolution by assisting employers or claimants ... information by conducting research and verifying information in order to mitigate fraud. Review and complete not 30x weekly benefit amount determinations. Review … more
- Highmark Health (Boston, MA)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- ASM Global (Boston, MA)
- …proceedings. Partner with the General Counsel to investigate and respond to employment claims and demand letters, as well as state and federal agency claims ... operations leaders for all event staff. + Talent Management - Manage performance review process. Partners with business leads to ensure employees are aware of… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- CVS Health (Boston, MA)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Beth Israel Lahey Health (Charlestown, MA)
- …back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication and ... Divisions. Provides quality customer service and serves as an exemplary representative of the Patient Financial Services team **Job Description:** **Essential Duties… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …to support product development and regulatory submissions. + Author and review INDs, NDAs, and other regulatory submissions, ensuring accuracy, completeness, and ... wider clinical development plans. + Serve as early-stage CMC representative of the department in effectively communicating program related...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Highmark Health (Boston, MA)
- …and report improper coordination of benefit billing practices through paid clams review . + Participate as pharmacy representative in onsite member appeals ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- Prime Therapeutics (Boston, MA)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- Weston & Sampson (Boston, MA)
- Weston & Sampson is seeking a Senior Resident Project Representative or Senior Construction Inspector for oversight and inspection of utility and infrastructure ... What you'll do: + Supervise subordinate consultant staff as appropriate. + Review contract documents and construction management requirements to identify and report… more