- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …guidelines. This position requires strong clinical and medical coding skills to review claims for medical necessity, appropriate coding, and pricing of ... and use existing documentation to develop and revise workflows. + Act as claims representative in corporate meetings involving changes in medical policy, pricing… more
- Elevance Health (Woburn, MA)
- …a check, or ask you for payment as part of consideration for employment. **Grievance/Appeals Representative II** + Job Family: CLM > Claims Support + Type: Full ... + Reference: JR110934 **Location:** + Massachusetts, Woburn **Description** **Grievance/Appeals Representative II** **Location:** Hybrid 500 Unicorn Park Drive Woburn,… more
- Beth Israel Lahey Health (Burlington, MA)
- …and interprets third party payments, adjustments and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts, ... and identifies denial/non-payment trends and reports them to the Billing Supervisor. 2 . Responds to incoming insurance/office calls with professionalism and helps to… more
- Takeda Pharmaceuticals (Lexington, MA)
- …materials, press releases, and sales training communications to support the promotional review process.** ** 2 . Medical and scientific slides housed in the ... **Job Description** **About the role:** **Join Takeda as a Medical Information & Review Manager where you will deliver high-quality, balanced and timely medical and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …to providers in that area. Duties include hands-on coding, documentation review , coding dictionary updates, rejections and denials, surgical coding, physician or ... _including but not limited to:_ **1. Coding Responsibilities:** + Provides review and/or coding of any professional services including but not limited… more
- State of Massachusetts (Boston, MA)
- …within the Department of Family Medical Leave (DFML). The Claims Examiner/Job Service Representative I will review claims escalated by the Contact Center ... * Claims Examiner/Job Service Representative I| Department...(MGL Chapter 175M and 458 CMR 2 .00) 2 . Investigate, analyze, and respond to complex claims… more
- Beth Israel Lahey Health (Burlington, MA)
- …professional services for appropriate use of CPT, ICD-9, ICD-10, HCPCS, Modifier usage/linkage. 2 . Periodic review of codes, at least annually or as introduced ... in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation... and appeals. Duties include hands on coding, documentation review and other coding needs for ICD-9, ICD-10. Works… more
- Tufts Medicine (Boston, MA)
- …terminology course to attain understanding of CPT and ICD diagnosis coding. 2 . Certified Revenue Cycle Representative (CRCR) **OR** Certified Professional Coder ... the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers...**Minimum Qualifications** **:** 1. High school diploma or equivalent. 2 . Two ( 2 ) years of experience in… more
- LogixHealth (Bedford, MA)
- …all data recorded is easily searchable/accessible via hyperlinks to client coding policies 2 . Monitor all emails received through Outlook and to ensure all internal ... up to date by following Coding Policy QA process 4. Execute the Annual Coding Policy Review project/push out all policies to clients for a review and to follow… more
- LogixHealth (Bedford, MA)
- …Duties and Responsibilities 1. Answer escalated calls as needed from representatives and resolve issues 2 . Review EOBs submitted by the staff for review and ... perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable...Specific Job Knowledge, Skill and Ability 1. Ability to review the work of others 2 . Ability… more
- LogixHealth (Bedford, MA)
- …supervisory experience highly desired. Specific Job Knowledge, Skill and Ability 1. Ability to review the work of others 2 . Ability to read and interpret ... Specialists when work load requires. Duties and Responsibilities 1. Review all write off requests submitted by the staff...by the staff and make necessary adjustments when needed 2 . Report any trends found from write off requests… more
- LogixHealth (Bedford, MA)
- …policies for new clients by pushing out coding policy questionnaire for a review and completion + Monitor and analyze internal and external communications to ... clients are being logged in the CRT Task library + Supervise Annual Coding Policy Review project that it is done correctly and timely by direct reports and assist in… more
- LogixHealth (Bedford, MA)
- …coder production, other specialties and consistently meet LogixHealth coding industry standards 2 . Monitor and track use of operational production tools to determine ... Identifying needs b. Posting internally c. Screening and interviewing candidates 10. Review and approve time and attendance records according to company standards… more
- Jacobs (Boston, MA)
- …on job progress, labor, equipment and material used. Acts as on-site Company representative and liaison with all state and local government officials as applicable. ... that has been initially requested by Radio Frequency Network group, through field review of actual site and by working with neighborhood private property owners,… more
- CVS Health (Cumberland, RI)
- …plans. Assist with the management of accurate and timely front-end processing of claims within payer guidelines. Possess the ability to influence and support your ... assistance where gaps are identified. Enhance and utilize ad-hoc metric review to provide consistent measurement and feedback of departmental expectations, success… more