- Humana (Boston, MA)
- …inbound call center or related customer service experience + Previous experience processing medical claims + Bilingual (English and Spanish); with the ability to ... caring community and help us put health first** The Grievances & Appeals Representative 4 manages client denials and concerns by conducting a comprehensive analytic… more
- Surgery Care Affiliates (Waltham, MA)
- …third party payers to ensure payments by primary and secondary payers and/or self -pay patients are accurate and timely. You will: + Work closely with insurance ... collecting payments from insurance companies as opposed from collecting from self -payers/individuals. + Works closely with payer provider relations representatives +… more
- State of Massachusetts (Boston, MA)
- *Lead Claims Examiner/Job Service Representative II| Department of Family & Medical Leave* The Program Integrity Claims Examiner/Job Service ... of Family Medical Leave (DFML). The Lead Claims Examiner/Job Service Representative II will review,...women, Black, Indigenous, and Persons of Color (BIPOC) may self -select out of opportunities if they don't meet 100%… more
- Guardian Life (Boston, MA)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... submit process improvement ideas to revise workflows and procedures. + Support claims initiatives by encouraging/providing relevant feedback and acting as a change… more
- Guardian Life (Boston, MA)
- …The Vocational Rehabilitation Consultant provides assessment of LTD, STD and Life claims , to determine claimants' level of functionality and provide evaluation of ... programs. The VRC must possess a thorough working knowledge of medical diagnoses and treatment modalities, criteria supporting vocational feasibility, and a… more
- Guardian Life (Boston, MA)
- …regulatory compliance support and monitoring of the Guardian Group Benefits Product, Claims and State Filing areas, with significant and specialized focus on support ... and oversight of Guardian's Absence Management and Paid Family and Medical Leave services, Group Disability and Supplemental Health products. The individual in this… more
- Sutherland Global Services (Boston, MA)
- …answering questions and resolving problems? Do you have any experience in the healthcare/ medical field or are you interested in pursuing a career in the field? ... and distraction-free dedicated workspace **Duties & Responsibilities;** + Assist providers with claims and claims investigations + Status Inquiries + Denial… more
- Stantec (Boston, MA)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. + Oversee and approve development and management of the Project ... + Proactive interface and communication with designated Client commercial representative , as appropriate + Prepare and issue Contractual written communications,… more
- Tufts Medicine (Boston, MA)
- …duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted ... claims , and performs appeals for non-clinical denials, etc. An...2. Two (2) years of experience in an automated medical billing and collection environment for a medical… more
- Cardinal Health (Boston, MA)
- …and pharmacy insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years experience ... needs of the patient and/or program * Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance… more
- Cardinal Health (Boston, MA)
- …and pharmacy insurance benefit practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years' experience ... needs of the patient and/or program + Resolve patient's questions and any representative for the patient's concerns regarding status of their request for assistance… more
- Gilead Sciences, Inc. (Boston, MA)
- …events, and other miscellaneous external expenditures. + Partner with Medical Scientists, National Account Managers, Therapeutic Center Specialists, Marketing, and ... and retention of technical and scientific product-related information. + A self -Motivated achiever who consistently surpasses personal goals and exceeds standards of… more
- Guardian Life (Boston, MA)
- …portfolio. + Able to collaborate cross-functionally with Product peers, Claims , Legal, Underwriting, Distribution, Finance, Service, Marketing, and Operations to ... to our colleagues. **Health Care** + Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender… more
- RTX Corporation (Andover, MA)
- …Protection; Marine Cargo/Transit, Workers Compensation/Employers Liability; Defense Base Act; Claims Coordination, Aviation, Auto liability, and General Liability + ... thinker + Superior communication skills + Exceptional attitude and work ethic + Self -motivated, able to work independently and under pressure. + Able to multitask… more
- Medtronic (Boston, MA)
- …Life below). As a key team member, this individual must be a highly motivated self -starter who is comfortable both collaborating as part of a larger team at the ... and identify third party portfolios for possible acquisition + Perform claims analysis, construction, and drafting + Ensure ongoing awareness of competitors'… more