- Highmark Health (Boston, MA)
- …charges. The incumbent will also conduct or assist with provider and subscriber investigations to verify the validity of services and charges; will monitor internal ... facility and professional provider over-payments. + Investigation Support: Assist with investigations : Assist in the interviews of customers and providers to obtain… more
- Dana-Farber Cancer Institute (Boston, MA)
- …Monday-Friday from 7am-3pm.** Receiving general direction from the Manager of Investigations , the Violence Prevention/Intervention Coordinator (VPIC) responds to ... and mitigates the impact of incidents in high-risk areas within the hospital to ensure the protection of Dana Farber employees, property, information, reputation and brand. This position represents the department of Public Safety by promoting the hospital… more
- Harvard University (Cambridge, MA)
- …Department Office Location:USA - MA - Cambridge Business Title:Deputy Title VI Coordinator and Case ManagerSub-Unit:Office of the President and Provost Salary Grade ... years of experience in civil rights compliance, human resources investigations , or related work. + At least 3 years...Reporting to the Secretary for Compliance and Title VI Coordinator , the Deputy Title VI Coordinator and… more
- Boston Public Schools (Boston, MA)
- …within the school district. This role involves performing and managing investigations , implementing educational programs, and providing consultation and support to ... objective, and confidential interviewing and fact-finding, thoroughly and accurately document investigations , write a clear and comprehensive final report, and offer… more
- Cardinal Health (Boston, MA)
- …of applicable regulations, standards, and operating procedures. + Conduct investigations /root cause analysis and formulate corrective action recommendations. + Show ... an understanding of the program requirements and be capable of conducting gap assessments based on those requirements. + Uphold quality standards that adhere to company, regulatory, and HIPAA policies and procedures. + Collaborate across various functions,… more
- Cardinal Health (Boston, MA)
- …regulations, standards and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- Cardinal Health (Boston, MA)
- …+ Experience conducting and documenting patient health insurance benefit investigations , prior authorizations, and appeals, preferred (2+ years) + Knowledge ... of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of Medical/Pharmacy billing and coding, preferred + Strong attention to detail is vital + Bilingual, preferred… more
- Cardinal Health (Boston, MA)
- …regulations, standards, and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- Harvard University (Cambridge, MA)
- …of 5 years of experience in civil rights compliance, human resources investigations , or related work. Additional Qualifications and Skills: + Comprehensive knowledge ... + Supporting the Associate Title VI and Title IX Coordinator , LDRs, and OGE/OCC staff members in the preliminary...assigned by the Associate Title VI and Title IX Coordinator . + Serving as secondary point of contact for… more
- Boston Public Schools (Boston, MA)
- …if so, refer the case to the Director of Compliance and Title IX Coordinator or the Assistant Director of Compliance; + Determining if formal communication is needed ... appropriate. + Supervise and train co op students + Assist with investigations , including conducting interviews, note taking, and collecting documents. + Oversee… more
- Prime Therapeutics (Boston, MA)
- …recommendations. + MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist) in the performance of job duties as ... + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the United States… more
- Children's Hospital Boston (Boston, MA)
- …during patient visits. Performs study procedures designated for the Study Coordinator . + Completing record abstraction of source documents, conducts required study ... reporting any to the PI, the study sponsor, and Committee on Clinical Investigations IRB. Updates protocol and amendment changes. + Assisting investigators in data… more