- 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
- 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
- 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
- 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
- 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
- Robert Half Finance & Accounting (North Andover, MA)
- …who enjoy a dynamic, collaborative work environment. Responsibilities: * Process and submit medical claims to insurance providers with precision and attention to ... receivable, recording payments and applying necessary billing adjustments. * Collaborate with healthcare staff to address and correct coding discrepancies. *… 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