• Clinical Documentation Specialist (Risk Adjustment…

    Commonwealth Care Alliance (Boston, MA)
    …and CPT/HCPCS coding activities **Desired Experience:** + 2+ years' experience in medical coding in ambulatory Care, Outpatient or Home Care Setting a plus ... position will support internal & external clinical and operational coding initiatives at Commonwealth Care Alliance ( CCA )....Specialist will serve as a primary resource in evaluating medical encounter notes/records housed either at CCA … more
    Commonwealth Care Alliance (06/07/25)
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  • Medical Policy Program Manager

    Commonwealth Care Alliance (Boston, MA)
    011200 CCA -Central Clin Ops Leadership **Position Summary:** The Medical Policy Program Manager is primarily responsible to research, analyze, develop, and ... eg, nursing, physical therapy, LICSW + Certified Professional Coder (CPC) + Medical Billing and Coding Certification **Required Experience:** + Minimum of… more
    Commonwealth Care Alliance (05/31/25)
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  • Manager, Medical Policy

    Commonwealth Care Alliance (Boston, MA)
    011200 CCA -Central Clin Ops Leadership **Position Summary:** The Manager, Medical Policy reports to the Director of UM, and manages the personnel and work of the ... + Demonstrate knowledge and understanding of the laws, regulations, CCA 's contracts and policies that pertain to CCA...analysis + Power point, excel and word proficiency + Medical Billing and Coding Certification **Language(s):** +… more
    Commonwealth Care Alliance (05/31/25)
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  • Member Service Rep

    Commonwealth Care Alliance (Boston, MA)
    …health-oriented field is preferred. Technical accreditation in the health care field (ie, Medical Assistant | Billing and Coding ) is a plus. Required Experience: ... 011520 CCA -Customer Service * Be a resource for CCAs...working in the health care industry front lines or medical setting preferred * Prior experience with service authorizations,… more
    Commonwealth Care Alliance (07/10/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …public health care programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding , Compliance, Payment Integrity and Analytics + Direct and ... 011250 CCA -Claims Hiring for One Year Term **Position Summary:**... Association (AMA) guidelines, etc.) + Advanced experience of medical terminology and medical coding … more
    Commonwealth Care Alliance (05/28/25)
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  • Sr Analyst, Scope Management

    Evolent (Boston, MA)
    …of coding updates from authoritative sources, including the American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS), Food and ... (RHIT) + Certified Hematology and Oncology Coder (CHONC) + Certified Coding Associate ( CCA ) + Certified Professional Coder (CPC) + Certified Coding … more
    Evolent (07/18/25)
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  • Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    011260 CCA -Revenue Cycle Management **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be ... Health Plan risk adjustment program activities including identifying gaps in coding and documentation * Prospective and retrospective reviews, analytics and… more
    Commonwealth Care Alliance (05/23/25)
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