- WelbeHealth (Boston, MA)
- ** Claims Audit Analyst ** At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option (PACE) to the most ... Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will provide ... claim query requests, claim retraction valuation and viability, support payment policies, support audit requests, assist in the development of a claim audit … more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …preferred or equivalent experience or training + Minimum of 5 years claims audit /quality assurance experience in healthcare required + Strong understanding ... hoc invoice reconciliation QA audits for BCBSMA's payment integrity programs. + Audit vendor claims data and invoices against plan enterprise warehouse… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, ... resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on… more
- AIG (Boston, MA)
- Join us as a Claims Analyst IV to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim Analyst IV, ... + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit... Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation of indemnity and expense exposure… more
- Verint Systems, Inc. (Boston, MA)
- …Learn more at www.verint.com . **Overview of Job Function:** The Benefits Analyst will be responsible for the day-to-day initiatives of all annual projects ... and effectively respond to escalations regarding benefit programs or claims issues + Conduct audits on benefit enrollments and...and employee deductions as needed to ensure accuracy + Audit , review and process all benefit invoices + Assist… more
- CVS Health (Woonsocket, RI)
- …every day. This is a hybrid position. **Position Summary** As a Rebate Formulary Analyst , you will perform a critical role in the analysis of Medicare and Commercial ... Support Services as they work with clients in the development of formularies; Rebate audit team as questions arise on audits by manufacturers and clients. + Adhering… more
- Leonardo DRS, Inc. (Fitchburg, MA)
- …to accurately interpret the results + Support of government compliance and audit activities + Understand standards of conduct to include: conflicts of interests; ... EVM, cost and pricing, C/SSR); risk management; return on investment (ROI); audit preparation and management; and program review preparation + Support, communicate,… more