- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Review makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Supervisor , Claims Review works within thorough, prescribed guidelines and… more
- Sedgwick (Boston, MA)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and… more
- Sedgwick (Boston, MA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Advisor, Environmental | Professional Liability | REMOTE **Job Description Summary** ... To analyze complex or technically difficult environmental claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
- State of Massachusetts (Boston, MA)
- …join our Victim Compensation team. Reporting to theDirector of Victim Compensation,the Claims Manager provides management and oversight of MOVA's Claims ... compensation program in accordance with Massachusetts statute and regulations. The Claims Manager implements trauma informed, victim and survivor centered systems… more
- Carrington (Boston, MA)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses ... this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE...manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but… more
- Ryder System (Boston, MA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- State of Massachusetts (Boston, MA)
- …the filing of claims for unemployment insurance benefits. The Contact Center Supervisor provides technical assistance and training to staff on all aspects of the ... claims taking process thereby ensuring that staff have an...of laws, regulations, policies, and procedures. The Contact Center Supervisor evaluates work product through the review … more
- Beth Israel Lahey Health (Burlington, MA)
- …initiate corrected claims and appeals. Duties include hands-on coding, documentation review , and other coding needs for ICD-9, ICD-10. Works directly with the ... toward process improvements within the Central Billing Office. 15. Assists the Billing Supervisor with the resolution of complex claims issues, denials, and… more
- Beth Israel Lahey Health (Charlestown, MA)
- …all Hospital Billing, Follow-Up, and Denial activities necessary to obtain payment/resolution of claims .** ** Review the entire account to ensure claims were ... all claims /data problems that cannot be handled to the Supervisor /Manager within one (1) day of identifying the problem.** **Identifies and researches… more
- Beth Israel Lahey Health (Charlestown, MA)
- …Communicates all claims /data problems that cannot be handled to the Supervisor /Manager within one (1) day of identifying the problem. + Identifies and researches ... a Remote work schedule. Under oversight of the Department Manager & Supervisor , the Patient Financial Services Representative - Hospital Billing will be responsible… more
- Beth Israel Lahey Health (Burlington, MA)
- …geared toward process improvements within the Central Billing Office. 16. Assists the supervisor with the resolution of claims issues, denials, appeals and ... for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement. The role also includes... for re-processing and reimbursement. The role also includes review and rework of all types of PFS denials.… more
- Cardinal Health (Boston, MA)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... receivable and increase cash flow for the organization. **_Responsibilities:_** + Review aging reports and work insurance accounts to ensure timely resolution… more
- Walgreens (Needham, MA)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels patients and answers questions ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist is responsible for ensuring that elements of… more
- Cardinal Health (Boston, MA)
- …to patient inquiries in a professional and timely manner. **_Responsibilities:_** + Review aging reports and work patient accounts to ensure timely resolution and ... billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs)… more
- Cardinal Health (Boston, MA)
- …payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with insurance carriers for reimbursement ... + Consults with appeals department for disputed / denied claims . + Works / Understands electronic claim interchange +...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- State of Massachusetts (Boston, MA)
- …from information received in writing or from Director; collect and review documentation, determine appropriate response; communicate with parties in writing and ... supportive documentation. * Answer telephone inquiries from telephone queue. * Review new laws, regulations, administrative bulletins, etc. to determine their impact… more
- Walgreens (Boston, MA)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist has the ultimate responsibility for ensuring that… more
- Beth Israel Lahey Health (Burlington, MA)
- …and movement disorders. As part of your responsibilities, you will proactively review provider appointment lists and patient chart notes to identify individuals who ... enrollment in available programs, handles customized communications, ensures ongoing claims processing accuracy and efficient delivery throughout the treatment… more
- Point32Health (Canton, MA)
- …**Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and ... skills in all interactions. This individual prepares cases for presentation, discussion, review , and final disposition at the Member Appeals Committee (MAC) and… more
- Beth Israel Lahey Health (Boston, MA)
- …limited to: 1. Conducts initial post-offer/pre-placement physical assessment, including review of immunization status, and provides required testing or immunizations ... provider or circumstances require. 5. Works with the employee's supervisor to ensure that the employee needing work restrictions...11. In the absence of a manager, files appropriate claims reports and works as liaison with physician and… more