- HCA Healthcare (Manchester, NH)
- …**Introduction** Do you want to join an organization that invests in you as a Medical Insurance Claims Appeals Representative? At Parallon, you come ... you have the opportunity to make a difference. We are looking for a dedicated Medical Insurance Claims Appeals Representative like you to be a part of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Utilization Management, Case Management, Member appeals and Grievance, Provider Service, Claims , Network Management, and Medical Policy teams. This role is ... our eWorker persona (remote). Key Responsibilities: + Review provider and member appeals utilizing sound clinical judgement, medical policy, clinical guidelines,… more
- Humana (Boston, MA)
- … Medical Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems ... Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Humana (Boston, MA)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. +… more
- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for ... LinkedIn. **Brief summary of purpose:** The Fallon Health (FH) Appeals and Grievance process is an essential function to...FH members and FH with their complaints regarding denied claims , referrals, membership, and benefit issues as well as… 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 ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Intermountain Health (Boston, MA)
- … follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims , and all aspects of insurance follow-up and collections. + ... responsible for performing a variety of complex duties, including working outstanding insurance claims follow-up for no response, unresolved from payors, and/or… more
- Children's Hospital Boston (Boston, MA)
- …to government/payer regulation and department policy/procedures. + Prepares and submits accurate insurance claims and appeals to payer within required ... responsible for the timely and accurate submission of all charges and claims as assigned and required to bring issue/problem identification and investigation through… more
- Cardinal Health (Boston, MA)
- …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- HCA Healthcare (Manchester, NH)
- …purpose and integrity. We care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Intermountain Health (Boston, MA)
- … follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims , and all aspects of insurance follow-up and collections. + ... Submit requested medical information to insurance carrier. Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work… more
- Cognizant (Boston, MA)
- …for discrepancies. + Communicate directly with payers to follow up on outstanding claims , file technical appeals , resolve payment variances, and ensure timely ... following benefits for this position, subject to applicable eligibility requirements: + Medical /Dental/Vision/Life Insurance + Paid holidays plus Paid Time Off +… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Effector Cell (IEC) therapies, including benefit verification, pre-certification, concurrent review, appeals , and preparation of cost estimates for insurance ... and we work with amazing partners, including other Harvard Medical School-affiliated hospitals. + Oversee the full lifecycle of...root cause analyses, and oversee the timely submission of appeals or corrected claims . + Develop and… more
- UIC Government Services and the Bowhead Family of Companies (Boston, MA)
- …of Defense and many federal agencies. Bowhead offers competitive benefits including medical , dental, vision, life insurance , accidental death and dismemberment, ... DHS in appellate proceedings before the Board of Immigration Appeals , and providing support and direction to the Department...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Cardinal Health (Boston, MA)
- …BS or equivalent experience in related field preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred + 1-2 years ... the patient journey. + Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. + Exhibit effective communication and… more
- Evolent (Boston, MA)
- …culture. **What You'll Be Doing:** **Analyst, Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL programs. ... innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers. Showcase… more