- 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
- 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
- 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)
- …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
- 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
- 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
- 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
- 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
- CVS Health (Boston, MA)
- …regulations. Stay informed about changes in the industry practices related to healthcare coding . Provide training opportunities for staff to maintain their ... healthcare fraud detection, investigation, or auditing In-depth knowledge of healthcare systems, claims processing, and regulatory requirements related to … more
- LogixHealth (Bedford, MA)
- … claims generated by staff on a daily basis + Attach primary EOBs to secondary claims + Attach medical records to claims as needed + Assist management ... 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
- Elevance Health (Woburn, MA)
- …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on… more
- CVS Health (Boston, MA)
- …+ Executes system setup and mapping of client level benefits to align with industry coding (ICD 10, place of service, healthcare reform, etc.), similar to entry ... working with healthcare . + 1+ year of experience working with medical terminology. **Preferred Qualifications** + 1-3 years of experience working quality, … more