• Inpatient DRG Quality Auditor

    Humana (Boston, MA)
    …is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for...modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum… more
    Humana (07/25/25)
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  • HCC Risk Adjustment Auditor - Full Time…

    Datavant (Boston, MA)
    …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity...a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in… more
    Datavant (08/01/25)
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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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  • Sr Compliance RCM & Coding Auditor

    Humana (Boston, MA)
    …business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring ... data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies and… more
    Humana (07/29/25)
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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 (08/02/25)
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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 (07/30/25)
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  • Operations Associate, Full Time Days, No Weekends

    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 (08/02/25)
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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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