- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding … more
- Elevance Health (Woburn, MA)
- …considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Highmark Health (Boston, MA)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- LogixHealth (Bedford, MA)
- …Diploma or equivalent combination of education and experience required 2. Baseline knowledge of medical coding or currently in a certification program is a plus ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- LogixHealth (Bedford, MA)
- …ien ce: Priorex pe r ie nce an dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification is a plus. Spe cificJ ob ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... /facility coder production, other specialties and consistently meet LogixHealth coding industry standards + Monitor and track use of...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Cognizant (Boston, MA)
- …+ Experience with encounter data submissions and resolution. + Knowledge of healthcare billing and coding regulations. + Data analysis and problem-solving ... world. Together, we're improving everyday life. **Job Summary** : The Claims Encounters Consultant is responsible for providing customers with application domain… more
- LogixHealth (Bedford, MA)
- …Excel, and Outlook Preferred: + One to two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We ... revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and… more
- Elevance Health (Newton, MA)
- …and will lead data management, share expertise regarding real world evidence (RWE)/ claims data and statistical analyses activities for healthcare research ... **Biostatistician - Healthcare Research** **Location:** This role requires associates to...drugs and other biologic interventions. + Uses a large claims database to conduct studies which focus on improving… more
- Ophthalmic Consultants of Boston (Plymouth, MA)
- …insurance companies, government payers, and other third-party entities. + Ensure accurate medical coding in compliance with relevant standards (eg, ICD-10, CPT) ... and detail-oriented Revenue Cycle Billing Manager to oversee and manage our healthcare organization's billing and claims processing operations. This role handles… more
- Humana (Boston, MA)
- …have** **a passion for healthcare ? Do you have a solid background in medical auditing, coding ** **,** **and medical record review?** **If** **you ... materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from … more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, administrators, and coders to provide cutting edge solutions that will… more
- Robert Half Accountemps (Pittsfield, MA)
- …in the healthcare revenue cycle by: + Preparing and submitting accurate medical claims to insurance companies + Verifying patient insurance coverage and ... regarding billing issues + Staying informed about changes in medical billing and coding regulations Requirements The...meet the following qualifications: + Experience: Proven experience in medical billing or a related role in healthcare… more
- Highmark Health (Boston, MA)
- …perform initial problem identification and resolution activities, and debug benefits and medical policy program coding . Document the results of problem ... a big impact for those we serve. This job performs highly complex benefit coding , new client and group installation, as well as set-up of network structures (eg… more
- LogixHealth (Bedford, MA)
- …years related experience + Experience with health information management, EMR systems, or medical coding + Data entry experience Benefits at LogixHealth: We ... desire to learn. Key Responsibilities: + Obtain and process medical charts + Audit the processed charts for accuracy...management services, offering a complete range of solutions, including coding and claims management and the latest… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- LogixHealth (Bedford, MA)
- …and will bring your expertise to facilitate payment of Emergency Department Physician medical claims . The ideal candidate will have strong technical skills, ... a daily basis + Attach primary EOBs to secondary claims + Attach medical records to ...management services, offering a complete range of solutions, including coding and claims management and the latest… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …reviews to verify the accuracy of claims reimbursement, clinical significance, medical necessity, coding and billing. + Comprehensive oversight of appeals, ... Ready to help us transform healthcare ? Bring your true colors to blue. What...individuals and serve as a subject matter expert in medical coding and billing, hospital outpatient and… more
- NASCO (Boston, MA)
- …requirements and coding computer applications + 4 years analyzing and coding healthcare insurance computer applications + 4 years of programming experience ... tackle moderate to complex technical challenges, enhancing data management and claims processing systems for NASCO and its partners. Collaborating with analytical… more