• Medicare / Medicaid Claims

    Commonwealth Care Alliance (Boston, MA)
    …and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and ... ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role...Management + Collaborate system and data configuration into CES ( Claims Editing System) with BPaaS vendor and… more
    Commonwealth Care Alliance (05/28/25)
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  • Inpatient DRG Quality Auditor

    Humana (Boston, MA)
    …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
    Humana (06/11/25)
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