- Sedgwick (Boston, MA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Claims Specialist , Professional Liability (Medical Malpractice) ... **PRIMARY PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury … more
- Zurich NA (Boston, MA)
- Sr . TPA Specialist , Complex Claims 125068 Zurich Insurance is currently looking for a Sr TPA Specialist . This position will oversee complex Liability ... analyzes highly complex coverage situations, evaluates high exposure claims , seeks/grants authority, assigns/explains reserves to senior ... claims according to US Best Practices. The Sr . TPA Specialist regularly communicates with TPAs,… more
- Sedgwick (Boston, MA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY ... PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims… more
- Trustmark (Boston, MA)
- …communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & Customer Experience group. The ... process and procedures and minimum of 2 years of experience in handling claims appropriately in accordance with the corporate claim philosophy, policy provisions and… more
- 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. +...customer service. + Take advantage of a variety of professional development opportunities that help you perform your best… 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, ... reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject... Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or… more
- Commonwealth Care Alliance (Boston, MA)
- …for One Year Term **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims ... Sr . Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...certified within 1 year of employment - + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) +… more
- Commonwealth Care Alliance (Boston, MA)
- … Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr . Specialist II is responsible for ensuring CCA's operational compliance with ... Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and works closely with Cognizant (TPA)… more
- Commonwealth Care Alliance (Boston, MA)
- …and operational coding initiatives at Commonwealth Care Alliance (CCA). The Clinical Documentation Sr . Specialist will serve as a primary resource in evaluating ... + Associate's Degree or equivalent experience + Possession of Certified Coding Specialist designation (CCS, CCS-P, CCA from AHIMA) or Certified Professional … more
- US Coast Guard (Boston, MA)
- …in Boston, Massachusetts. Responsibilities You will serve as a Supervisory Contract Specialist and be responsible for the development of acquisition strategy through ... and any outlying detachments. Provides technical assistance and guidance to support senior management and program personnel and directs the activities of subordinate… 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