- Neighborhood Health Plan of Rhode Island (Smithfield, RI)
- …Shift Daytime Job Category Professional / Experienced Description The Policy and Claims Research Specialist is responsible for supporting the Payment ... act as the point of contact for claim related research . Serves as a claims subject matter...expert (SME) and resource/support for claim edit and payment policy initiatives Conducts in-depth research on complex… more
- Lincoln Financial (Boston, MA)
- …on financial calculations with team members that involve complex contract provisions. + Research questions and escalations from Claims team; liaises with various ... 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product...product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Payment Integrity Program Manager, the Payment Integrity Consultant uses industry knowledge, research skills, payment policy and business operations knowledge to ... drug fee schedules, including assessing and pricing new codes + Analyze claims data in conjunction with provider reimbursement methodologies and external benchmarks… more
- USAA (Boston, MA)
- …us special and impactful. **The Opportunity** As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, ... evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will...in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for… more
- Beth Israel Lahey Health (Burlington, MA)
- …provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and ... Coding Manager to resolve complex issues and denials through independent research and assigned projects. **Job Description:** **Essential Duties & Responsibilities**… more
- GAP Solutions Inc (Boston, MA)
- **Position Objective:** As a Junior Human Resource Specialist , apply HR skills in support of managers, program staff and customers on the full range of HR topics ... classification, processing, benefits, recruitment, compensation, SES programs, work life programs, policy and employee and labor relations. In support of the Dept.… more
- Carrington (Boston, MA)
- …Bankruptcy Ledger Experience Required to be Considered!** The Bankruptcy Ledger Specialist will be responsible for completing and monitoring ledgers through the ... high degree of accuracy, for all Bankruptcy processes including Acquisitions, Proof of Claims , Notice of Final Cures, Motions for Relief, Agreed Orders, Notices of… more
- Charles River Laboratories (Cambridge, MA)
- …+ Assist in the investigation of injuries resulting in lost time claims and/or safety violations and property damage. Make recommendations for corrective action. ... matters. + May assist in development of departmental budget. + Support the policy of equal employment opportunity through affirmative action in personnel actions. +… more
- Highmark Health (Boston, MA)
- …Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means deeply engaging with graph theory, building and enriching ... treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development, specializing in Graph Intelligence, who will not just… more
- Philips (Cambridge, MA)
- …notably University of Texas Southwestern Medical Center) with a focus on research , development, and evaluation of new medical applications for Magnetic Resonance ... imaging., **Your role:** + Will guide, conduct, and support research and advanced clinical applications for the Magnetic Resonance...in North America. + Will be the expert MRI specialist in an assigned technical or clinical application area,… more
- Highmark Health (Boston, MA)
- …or required including training/mentoring of new staff, performing audits and research related to special projects and providing coverage for coding manager(s). ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more
