- Sedgwick (Boston, MA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY ... PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims… more
- Prime Therapeutics (Boston, MA)
- …of that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Specialist Sr **Job Description** The Claims Specialist ... accredited institution or equivalent GED + 1 year of claims experience + Must be eligible to work in...simultaneously **Preferred Qualifications** + 2+ years of experience in claims , insurance, or healthcare + Extensive experience using Excel… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, ... complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on Medicaid… more
- Commonwealth Care Alliance (Boston, MA)
- …considered at this time._** **Position Summary:** Working under the direction of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical ... 011250 CCA- Claims Hiring for One Year Term **_This position...Sr . Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and… more
- CVS Health (Boston, MA)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Boston, MA)
- …following: + Executes both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from ... and timely support. + Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements as well as daily operations… more
- CVS Health (Boston, MA)
- …do it all with heart, each and every day. **Position Summary** The ** Senior Accounts Receivable Specialist ** prepares accounting and financial records and ... monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+… more
- Commonwealth Care Alliance (Boston, MA)
- … Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr . Specialist II is responsible for ensuring CCA's operational compliance with ... 011250 CCA- Claims **_This position is available to remote employees...CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and works closely… more
- Beth Israel Lahey Health (Burlington, MA)
- …functions that cover an enterprise-wide scope, the Revenue Cycle Operations Specialist role is responsible for identifying, researching, and resolving various ... for all commercial and government payors. The Revenue Cycle Operations Specialist 's duties primarily involve registration error, coverage, and eligibility related… more
- Prime Therapeutics (Boston, MA)
- …+ MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist ) in the performance of job duties as assigned. + ... drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more
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