- Sedgwick (Boston, MA)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Estimate Review Specialist Sr . (Repair Solutions) **PRIMARY PURPOSE:** To review all estimates ... your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...+ We offer a diverse and comprehensive benefits including medical , dental vision, 401K, PTO and more beginning your… more
- Citizens (Medford, MA)
- …to continuously learn, consider a career at Citizens as a Fraud Customer Support Sr . Specialist . In this role, you'll play a crucial part in safeguarding ... the customer's consent on a resolution. + Provide accurate complete claims processing, and records management using established procedures in moving/placing… more
- Sedgwick (Boston, MA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Life Science Claims Specialist (REMOTE US) **PRIMARY PURPOSE** ... **:** To analyze complex claims specific to the product liability / life sciences...deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will ... specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims , settlement, claims… more
- Fujifilm (Boston, MA)
- **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance Program's operations to ensure high ... + Keep abreast of new legislation and enforcement matters relevant to the medical device industry as well as industry and compliance best practices. + Perform… more
- CVS Health (Boston, MA)
- …handle customer service inquiries and problems. Additional Responsibilities - Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Highmark Health (Boston, MA)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Tufts Medicine (Boston, MA)
- …Health, within the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston. The Senior Research Associate will work both ... knowledge and skills typically acquired through advanced education. A specialist level role that is a recognized subject matter...and publish manuscripts, analyze large datasets (eg, health care claims data and electronic medical record) to… more
- United Therapeutics (Boston, MA)
- …you drive a culture of compliance with confidence and enthusiasm. The Senior Corporate Compliance Manager - Training, Communications and Policy will be responsible ... team members, consultants and stakeholders + Manage Corporate Compliance Operations Specialist II, who is responsible for administration of compliance training and… more
- Highmark Health (Boston, MA)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- Medtronic (Boston, MA)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more