- …Role at a Glance** We are excited to bring on an Associate , Claims Investigator to our Group Protection Special Investigations Team in Charlotte, NC; Omaha, ... of Bachelor's) (Minimum Required) + 0 - 1+ Years experience in claims investigation directly aligned to the specific responsibilities for this role. (Required)… more
- Highmark Health (Boston, MA)
- …and Thursdays This job is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of ... information in applicable case management tracking systems. **ESSENTIAL RESPONSIBILITIES** + Claims Reviews/ Investigation : Arrange for collection of claims … more
- Commonwealth Care Alliance (Boston, MA)
- …validation. + Escalate systemic or high-impact discrepancies to the Director of Claims Operations and Quality Assurance for further investigation or ... 011250 CCA- Claims Job Description **Position Summary:** Reporting to the...have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or… more
- Chewy (Boston, MA)
- …with R&D, Supply Chain, Operations, Legal, Marketing, and Quality. The Associate Director will also drive compliance investigations , supplier accountability, ... standards of regulatory compliance, quality assurance, and ethical sourcing. The ** Associate Director, Global Compliance & Ethical Sourcing** will define and lead… more
- RTX Corporation (Boston, MA)
- …groups. + Manage outside counsel and co-manage with Raytheon litigation counsel claims and supply chain litigation matters. + Support supply chain advisors and ... with drafting, reviewing and negotiating complex supplier and government claims . Typical involvement includes investigating and supporting the development of… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Senior Physician Billing Associate (Shared Service Center - Westwood)Department:Shared Service CenterAutoReqId:78840BRStatus:Full-TimeStandard ... responsible for the timely and accurate submission of all charges and claims as assigned and required to bring issue/problem identification and investigation… more
- Travelers Insurance Company (Boston, MA)
- …of businesses of all sizes. The BSI Claim Counsel team conducts thorough investigation , analysis, evaluation, and disposition of claims and claim litigation to ... optimize claim results. Travelers' Cyber Claim Team is responsible for handling claims focusing on cyber privacy and security breach incident response, computer… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …us transform healthcare? Bring your true colors to blue. What we need The Associate Director of Clinical Data Management will be a key leader in executing BCBSMA's ... in context of healthcare providers (EHR, EMRs) and payors ( Claims , Labs, ADTs, Quality measures). + Excellent understanding and...and that work/life balance is a key part of associate wellbeing. For more information on how we work… more
- State of Massachusetts (Brockton, MA)
- …rehabilitation counseling, educational counseling, credit collection, credit interviewing, credit investigation , claims adjudication, claims settlement, ... employers and/or their representatives. * Analyzes data obtained from investigations and applies relevant laws, rules, regulations and precedents...claims examining, claims , investigation , claims interviewing, social work or social… more
- State of Massachusetts (Brockton, MA)
- …rehabilitation counseling, educational counseling, credit collection, credit interviewing, credit investigation , claims adjudication, claims settlement, ... claims examining, claims , investigation , claims interviewing, social work or social...required experience and the substitutions below. Substitution: I. An Associate 's degree may be substituted for one (1) year… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …your true colors to blue. What We Need Reporting to the Associate Director of Professional Reimbursement Strategy, the Payment Integrity Reimbursement Policy Quality ... audit reviews and core functions include reconciling vendor invoiced claims against finalized paid claims to identify...and that work/life balance is a key part of associate wellbeing. For more information on how we work… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …or medical device product candidates. + Interpret and communicate results of Phase I-IV investigations in preparation for a new drug. + Be the signatory on NDA ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director is typically...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …or medical device product candidates. + Interprets and communicates results of Phase I-IV investigations in preparation for a new drug. + Acts as the signatory on ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director and 6-9...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …expert in cutting edge data science techniques; experience with healthcare data, and especially claims , is a major plus. We are looking for someone to work closely ... and delivery of data solutions + Direct experience with claims data a major plus + BA/BS required; MS,...and that work/life balance is a key part of associate wellbeing. For more information on how we work… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. Reports to the Associate Director of Project Portfolio Management. The Program Manager of Production Operations ... other Production Operations duties + Oversee Medicare Part D Claims audits to ensure that all MAPD and PDP...and that work/life balance is a key part of associate wellbeing. For more information on how we work… more
- Humana (Boston, MA)
- …and/or state requirements related to Provider Clinic operations, billing, investigations , and processes. Coordinates site visits for regulators, coordinates ... cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must… more
- Robert Half Legal (Boston, MA)
- …to work on challenging legal matters alongside a talented team. Role: Associate Attorney Salary: $180,000 - $275,000 (depending on experience) + great benefits! ... cases in both federal and state courts nationwide. + Perform in-depth factual investigations and legal analysis of prospective and ongoing securities and derivative … more
- Carrington (Boston, MA)
- …system, including but not limited to, analyzing complaints, investigating claims , retaining outside counsel where appropriate and providing outside counsel ... circulating agreements for signature. + Take lead in pre-claim title investigation /review, including reviewing title records, organizing documents and creating a… more
- Mentor Technical Group (Boston, MA)
- …required reports of EHS system performance including but not limited to investigation reports, injury reports, insurance claims , performance metric reports, etc. ... work environment for all employees. + Participate in the investigation of incidents, near misses and property damage incidents....will be highly preferred. + In lieu of degree, Associate degree diploma with 10+ years of experience required… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …around our primary enterprise assets including core payer system for claims processing, member enrollment, provider management, and benefits administration. + Lead ... and that work/life balance is a key part of associate wellbeing. For more information on how we work...formal complaint or charge, (b) in furtherance of an investigation , proceeding, hearing, or action, including an investigation… more