• Medical Coding Auditor Evaluation…

    Humana (Boston, MA)
    …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... established guidelines/procedures. **Where you come in** The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates… more
    Humana (07/24/25)
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  • Coding Auditor Educator

    Highmark Health (Boston, MA)
    …and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
    Highmark Health (05/09/25)
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  • Compliance Auditor -Per Diem-Day Shift

    Baystate Health (Springfield, MA)
    …the work is administrative. **Job Responsibilities:** **1)** Performs detailed reviews of clinical documentation for provider services using MDAudit based on ... to ensure it meets the AMA and CMS (Medicare) guidelines for the services billed, reviewing and validating billed charges and performing benchmark reporting to… more
    Baystate Health (06/23/25)
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  • Senior Inpatient Medical Coding Auditor

    Humana (Boston, MA)
    …us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records and assigns appropriate ... our customers and our company. Through our Humana insurance services and CenterWell healthcare services , we make...achieve their best health - delivering the care and service they need, when they need it. These efforts… more
    Humana (06/26/25)
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  • Human Research Quality Manager, School…

    Boston University (Boston, MA)
    …or monitor/ auditor is needed. + Experience with conduct of clinical research either with pharmaceutical/device clinical trials and or observational ... or monitor/ auditor is needed. + Experience with conduct of clinical research either with pharmaceutical/device clinical trials and or observational… more
    Boston University (07/09/25)
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  • Operations Associate Cardiac Monitor Tech, Part…

    Baystate Health (Springfield, MA)
    …retirement company match & annual company contribution increase based on years of service + Free money coach advice from a certified professional + Wellbeing ... + HS Diploma/GED + 1-2 years experience in customer service (healthcare setting preferred) + Medical administrative experience strongly...also as a business partner to the department and clinical staff. Orients patients and families to the unit,… more
    Baystate Health (07/08/25)
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  • Operations Associate, Full Time, Nights, Emergency…

    Baystate Health (Springfield, MA)
    …retirement company match & annual company contribution increase based on years of service + Free money coach advice from a certified professional + Wellbeing ... experience strongly preferred + 1-2 years' experience in customer service (healthcare setting preferred) + Ability to work rotating...also as a business partner to the department and clinical staff. Orients patients and families to the unit,… more
    Baystate Health (07/20/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements ... Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration… more
    Commonwealth Care Alliance (05/28/25)
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  • Auditing & Compliance Director - Software as…

    Wolters Kluwer (Waltham, MA)
    …action (CAPA)plans, with oversight of complaint trending, post-market surveillance, clinical evaluation, design control, and risk management activities. You will ... also work cross functionally within the business teams in Legal, Regulatory, Clinical , Marketing, and Product Development and within the broader Wolters Kluwer… more
    Wolters Kluwer (06/11/25)
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