- Commonwealth Care Alliance (Boston, MA)
- …Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing prospective claims auditing ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics… more
- Prime Therapeutics (Boston, MA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Senior Financial Analyst - Remote **Job Description Summary** This position requires ... and resolving complex problems and issues. + If supporting Medicare Part D, will be responsible for implementing CMS...adjust focus **Reporting Structure** + Reports to Manager or Sr Director in the Finance department **Responsibilities** + 3+… more
- Highmark Health (Boston, MA)
- …consistent data flows to business and stakeholders. Ensures data integrity and compliance by performing data cleansing, data audit and/or data validation. Performs ... analysis in the develop and support of HEDIS and Medicare Star data analysis. Determines how decision support systems...to business and stakeholders. + Ensure data integrity and compliance by performing data cleansing, data audit and/or data… more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr . Director, TPA Management and Claims Compliance , the Payment Integrity (PI) Recovery Analyst will assist in the development ... reimbursement, public health care programs and reimbursement methodologies (Medicaid and Medicare ) + Medical Coding, Compliance , Payment Integrity and Analytics… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Strategy Analyst position is responsible for efforts to strategically manage the ... portfolio of products across all states. The Analyst is responsible for analyzing and recommending improvements and...data to analyze market and product data across all Medicare market segments in all states to develop strategies… more
- Commonwealth Care Alliance (Boston, MA)
- …This is an individual contributor role. Working under the direction of the Sr . Director, TPA Management and Claims Compliance , Medical/BH Reimbursement Policy ... corporate reimbursement policies, and works collaboratively with the Claims Coding Analyst to ensure consistency with the Plan's claims processing system(s) +… more