- Lincoln Financial (Boston, MA)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and...lieu of Bachelor's) + 1 - 3+ Years of Short -Term and/or Long-Term Disability. (Required) + Ability to communicate… more
- CVS Health (Boston, MA)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... _fully insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing… more
- Cognizant (Boston, MA)
- …variances and take action to resolve account including drafting and submitting technical appeals . . Examine denied and underpaid claims to determine the reason ... **Accounts Receivable Specialist (remote)** This is a remote position open...Communicate directly with payers to follow up on outstanding claims , file technical appeals , resolve payment variances,… more
- CVS Health (Boston, MA)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Elevance Health (Smithfield, RI)
- …Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case ... and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all...may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding… more
- Cardinal Health (Boston, MA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure...day with myFlexPay + Flexible spending accounts (FSAs) + Short - and long-term disability coverage + Work-Life resources +… more