- Health New England (Lowell, MA)
- SUMMARY: The Payment Integrity / Special Investigation Unit (PI/SIU) Specialist is responsible for managing the audit functions across all lines of business ... waste and abuse (FWA) activities for HNE. The PI/SIU Specialist is responsible for developing, executing and overseeing a...- Perform audits on-site, electronically or in the field. Payment Integrity 20% - Research, interpret and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. Reporting to the Payment Integrity Program Manager, the Payment Integrity Consultant ... and prioritizing development needs and requirements + Participate in facility reimbursement payment integrity activities that include developing new payment … more
- Commonwealth Care Alliance (Boston, MA)
- …and fee schedule issues. + Collaborate closely with Provider Relations, Contracting, Payment Integrity , Appeals & Grievances, and Configuration teams to validate ... (eg, DRG, APC, RBRVS). + Support provider appeal reviews and internal payment integrity investigations by providing reimbursement validation. + Escalate systemic… more
- Commonwealth Care Alliance (Boston, MA)
- …revised coding logic, related Medicare/Medicaid policies for review/approval through the Payment Integrity governance process. **Supervision Exercised:** + No, ... and make recommendations based on new/revised coding edits for presentation to Payment Integrity committee meetings. + Analyze, measure, manage, and report… more
- Beth Israel Lahey Health (Burlington, MA)
- …facilitating process improvements - all in an effort to ensure that document integrity is sound and in line with payer expectations, contributing to favorable ... revenue cycle. The Operational Specialist position will have an impact on provider, patient,...processes, contributing to the provision of accurate and high integrity documentation, and streamlined workflows. **Job Description:** Essential Duties… more
- Lincoln Financial (Boston, MA)
- …Glance** We are excited to bring on a **Complex Corrections & Suspense Operations Specialist ** to join our Retirement Plan Services business in a work from home ... a highly skilled and detail-oriented Complex Corrections & Suspense Operations Specialist to provide strategic oversight and subject matter expertise across key… more
- Curtiss-Wright Corporation (Tewksbury, MA)
- **Business Development Specialist , Lead** Here in Tewksbury, Massachusetts, we are seeking an experienced and strategic Business Development Specialist , Lead. ... to any Curtiss-Wright employee or affiliate will not qualify for fee payment , and therefore become the property of Curtiss-Wright._ **Compliance Statement** This… more
- EDB (Boston, MA)
- …visit www.enterprisedb.com **Job Description:** We are seeking a Demand Generation Specialist to join our marketing team. This role will actively contribute ... of our culture and are key to our company's integrity . EDB does not seek or accept unsolicited resumes...not pay, any fees, commissions, or any other similar payment related to unsolicited resumes or CVs except as… more
- Lincoln Financial (Boston, MA)
- …this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... services. With our 120-year track record of expertise and integrity , millions of customers trust our solutions and service...chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer… more
- NTT America, Inc. (Boston, MA)
- …to multi-cultural environments - displaying cultural sensitivity + Displays personal integrity and adheres to NTT Group values + Excellent communication (written ... + Adaptability to multi-cultural environments - displays cultural sensitivity, personal integrity , and adherence to NTT values **Attributes** + Ability to coach… more
- Sharecare (Boston, MA)
- …peers. They will be innovative, open to change, and display honesty and integrity in all that they do. **Essential Job** **Functions:** + Process FMLA/Short Term ... incoming requests for PHI. + Ensure patient's disability forms are completed after payment within 5-7 days (turnaround). + Pull patients forms and PHI requests on… more
- Tufts Medicine (Burlington, MA)
- …hospital setting 4. Three (3) years' experience in Clinical Documentation Improvement/ Integrity 5. Advanced clinical expertise and extensive knowledge of complex ... activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following CDI… more
- Elevance Health (Woburn, MA)
- …considered for employment, unless an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of ... companies, Carelon Insights, formerly Payment Integrity , is determined to recover, eliminate...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Mastercard (Boston, MA)
- …needs of small businesses. We are looking for a Director, Small Business Sales Specialist for the North American market to help drive growth in the segment through ... dynamic sales pipeline, and closing deals. Role - Director, Small Business Sales Specialist In this SMB commercialization role within the Regional Product team, the… more
- CDM Smith (Boston, MA)
- …**Business Unit:** FSU **Job Description:** CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims. This role is critical in ... property damage, business interruption, and other loss categories. The specialist will conduct thorough forensic investigations to identify discrepancies, detect… more
- CenterWell (Boston, MA)
- …Home Health is seeking a highly skilled Operations Research & Workforce Analytics Specialist to join our Data Driven Transformation team. This role focuses on ... a team + Strong ethical standards and commitment to integrity + Adaptable and able to thrive in a...Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Home or Hybrid… more
- GovCIO (Boston, MA)
- …proposal. The Desktop Systems Engineer 3 performs as a technical specialist and diagnostician responsible for troubleshooting, problem solving, and maintaining ... with desktop standards, desktop management, software deployment, systems administration, and data integrity and recovery. Broad direct contact and work with users of… more
