• Appeals and Grievance Analyst

    Point32Health (MA)
    …(https://www.point32health.org/) . **Job Summary** Under the general direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
    Point32Health (08/16/25)
    - Related Jobs

  • Public Records Attorney

    State of Massachusetts (Boston, MA)
    …Records ( Supervisor ), the Division processes and issues determinations on appeals from petitioners denied access to government records; responds to inquires ... case-law, statutes, regulations, Attorney General Opinions, Executive Orders and prior Supervisor Determinations; . Review appeals from public records requesters… more
    State of Massachusetts (08/29/25)
    - Related Jobs

  • Appeals and Grievances Program Advisor

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...Federal and State Regulations. Complete individual summary scorecards for Supervisor feedback. + Track monthly scores on spreadsheet and… more
    Commonwealth Care Alliance (06/06/25)
    - Related Jobs

  • Supervisor Dental Government Business…

    Highmark Health (Boston, MA)
    …correspondence inquiries (routine, priority Congressional / Department of Defense), and appeals . Ensures that all processes are compliant with requirements and ... performance standards are consistently met. Responsibilities include: provides supervisor direction, scheduling and support for customer service representatives on… more
    Highmark Health (08/22/25)
    - Related Jobs

  • Supervisor , Customer Service & Patient…

    Children's Hospital Boston (Boston, MA)
    81586BRJob Posting Title: Supervisor , Customer Service & Patient Collections (Shared Serv Ctr)Department:Shared Service ... professional relationships with representatives of payer organizations to facilitate appeals of payer decisions; interpret regulation or policy; gather information… more
    Children's Hospital Boston (08/11/25)
    - Related Jobs

  • Case Management Supervisor

    State of Massachusetts (Boston, MA)
    …that align with level-of-care standards and payer requirements. * Coordinate appeals and reconsideration processes with managed care agencies and third-party payors. ... **Job:** **Medical Services* **Organization:** **Department of Public Health* **Title:** *Case Management Supervisor * **Location:** *Massachusetts-Boston-170 Morton Street* **Requisition ID:**… more
    State of Massachusetts (08/09/25)
    - Related Jobs

  • Lead Safety & Occupational Health Manager

    Veterans Affairs, Veterans Health Administration (Brockton, MA)
    …informal complaints of employees and refer others, such as formal grievances and appeals , to the supervisor or an appropriate management official. Articulates ... and communicates to the team the assignment, project, problem to be solved, actionable events, milestones, and/or program issues under review, and deadlines and time frames for completion. Ensures the organizational strategic plan, mission, vision and values… more
    Veterans Affairs, Veterans Health Administration (08/08/25)
    - Related Jobs

  • Public Records Division Public Records Specialist

    State of Massachusetts (Boston, MA)
    …Records ( Supervisor ), the Division processes and issues determinations on appeals from requestors denied access to government records; responds to questions ... driven environment and will be responsible for providing support to the Supervisor , Staff Attorneys and Division in administering the Massachusetts Public Records… more
    State of Massachusetts (08/23/25)
    - Related Jobs

  • Denial Specialist, Professional Billing-Remote

    Beth Israel Lahey Health (Burlington, MA)
    …interpret third-party payments, adjustments, and denials. Initiates corrected claims, appeals , and analyzes unresolved third-party and self-pay accounts, initiating ... overpayments, credits, and undistributed balances. Works directly with the Billing Supervisor to resolve complex issues and denials through independent research and… more
    Beth Israel Lahey Health (08/15/25)
    - Related Jobs

  • Billing & Certified Coding Specialist II

    Beth Israel Lahey Health (Burlington, MA)
    …in order to determine appropriate coding and initiate corrected claims and appeals . Duties include hands on coding, documentation review and other coding needs ... for ICD-9, ICD-10. Works directly with the Billing Supervisor and Coding Manager to resolve complex issues and...with the resolution of complex claims issues, denials and appeals . 16. Completes projects and research as assigned. 17.… more
    Beth Israel Lahey Health (08/08/25)
    - Related Jobs