- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding … more
- Humana (Boston, MA)
- …**Where you Come In** Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle ... community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from...payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments.… more
- Elevance Health (Woburn, MA)
- …considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Highmark Health (Boston, MA)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- Cognizant (Boston, MA)
- …+ Experience with encounter data submissions and resolution. + Knowledge of healthcare billing and coding regulations. + Data analysis and problem-solving ... world. Together, we're improving everyday life. **Job Summary** : The Claims Encounters Consultant is responsible for providing customers with application domain… more
- LogixHealth (Bedford, MA)
- …ien ce: Priorex pe r ie nce an dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification is a plus. Spe cificJ ob ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- LogixHealth (Bedford, MA)
- …Diploma or equivalent combination of education and experience required 2. Baseline knowledge of medical coding or currently in a certification program is a plus ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... /facility coder production, other specialties and consistently meet LogixHealth coding industry standards + Monitor and track use of...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medical Coding Coordinator 3 extracts clinical information from a variety of ... medical codes (eg, ICD-10-CM, CPT) to patient records. The Medical Coding Coordinator 3 performs advanced administrative/operational/customer support duties… more
- LogixHealth (Bedford, MA)
- …Excel, and Outlook Preferred: + One to two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We ... revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting… more
- Elevance Health (Newton, MA)
- …and will lead data management, share expertise regarding real world evidence (RWE)/ claims data and statistical analyses activities for healthcare research ... **Biostatistician - Healthcare Research** **Location:** This role requires associates to...drugs and other biologic interventions. + Uses a large claims database to conduct studies which focus on improving… more
- Humana (Boston, MA)
- …have** **a passion for healthcare ? Do you have a solid background in medical auditing, coding ** **,** **and medical record review?** **If** **you ... materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from … more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... Billing Specialist at LogixHealth, you will work with a team of fellow medical billers, administrators, and coders to provide cutting edge solutions that will… more
- Highmark Health (Boston, MA)
- …perform initial problem identification and resolution activities, and debug benefits and medical policy program coding . Document the results of problem ... a big impact for those we serve. This job performs highly complex benefit coding , new client and group installation, as well as set-up of network structures (eg… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background,...but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes… more
- LogixHealth (Bedford, MA)
- …and will bring your expertise to facilitate payment of Emergency Department Physician medical claims . The ideal candidate will have strong technical skills, ... a daily basis + Attach primary EOBs to secondary claims + Attach medical records to ...management services, offering a complete range of solutions, including coding and claims management and the latest… more
- CVS Health (Boston, MA)
- …regulations. Stay informed about changes in the industry practices related to healthcare coding . Provide training opportunities for staff to maintain their ... healthcare fraud detection, investigation, or auditing In-depth knowledge of healthcare systems, claims processing, and regulatory requirements related to … more
- LogixHealth (Bedford, MA)
- … claims generated by staff on a daily basis + Attach primary EOBs to secondary claims + Attach medical records to claims as needed + Assist management ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Elevance Health (Woburn, MA)
- …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on… more