• Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance , the Claims Sr. Analyst plays a critical role in ensuring ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance ,...reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject… more
    Commonwealth Care Alliance (05/31/25)
    - Related Jobs
  • Claim Analyst IV (Lexington), Professional…

    AIG (Boston, MA)
    Join us as a Claims Analyst IV to take on key...+ You will also contribute to continuous improvement in Claims by supporting Quality Assurance / ... within a world-class claims function. Make your mark in Claims As a Claim Analyst IV, you will be responsible for handling all aspects of multi-line,… more
    AIG (07/10/25)
    - Related Jobs
  • Health Policy Analyst

    Center For Health Information And Analysis (Boston, MA)
    …Data Integrity: Participate in advancing comprehensive practices in documentation, data quality assurance , and management. Your meticulous attention to detail ... in health policy impact! We seek a Health Policy Analyst to support projects, share content expertise, and provide...with an extensive range of health care enrollment, spending, quality , and claims data. You will be… more
    Center For Health Information And Analysis (07/08/25)
    - Related Jobs
  • Fraud Operations Analyst

    Cambridge Savings Bank (Waltham, MA)
    …cross functional initiatives, managing internal relationships, system enhancements, quality assurance audits, process improvement reviews, training ... POSITION: Fraud Operations Analyst Summary: At Cambridge Savings Bank, our purpose...activity reviews and trends, during Department meetings, and during quality control assessments. Exercise judgment within defined procedures and… more
    Cambridge Savings Bank (07/02/25)
    - Related Jobs
  • Appeals & Grievances Analyst

    Point32Health (Watertown, MA)
    …is compliant with the regulatory requirements set-forth by NCQA (National Committee for Quality Assurance ), DOI (Dept of Insurance), CMS, DOL and any state ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… more
    Point32Health (08/07/25)
    - Related Jobs
  • IT Business Systems Analyst - ScriptMed…

    Prime Therapeutics (Boston, MA)
    …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... decision we make. **Job Posting Title** IT Business Systems Analyst - ScriptMed - Remote **Job Description** The IT...of security implications of domain + Experience in Prime claims systems + Proficiency in Visio, Microsoft Word, Excel,… more
    Prime Therapeutics (07/11/25)
    - Related Jobs
  • Medicaid Provider Hospital Reimbursement…

    Humana (Boston, MA)
    …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral… more
    Humana (07/29/25)
    - Related Jobs