- Point32Health (Canton, MA)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- State of Massachusetts (Boston, MA)
- …*General Job Description:* Provides technical support and assistance to the Office of Appeals in evaluating net response and removal costs claimed by applicants in ... GL c.63, | 38Q and GL c. 62, | 6(j). * Coordinates findings with the Appeals Officer assigned to the case. Documents to be reviewed include, but are not limited to… more
- Intermountain Health (Boston, MA)
- …the patient's account within Intermountain's policies and procedures. Revenue Integrity Analyst II 1.Analyze data, develop reports, review trends, and recommend ... updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7.… more
- Intermountain Health (Boston, MA)
- …reports and surveys, reviews audit adjustments and settlements, and files appeals and exception requests to appropriately maximize reimbursement. Interacts with ... Medicare Administrative Contractor, State Medicaid, and hospital personnel as needed. + Acts as a mentor. As assigned, coordinates training, direction and review of those working with reimbursement functions. + Manages scope and completion of work, meeting… more