- 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
- AON (MA)
- Aon is looking for a Property Claims Specialist to fill a virtual role! This position is responsible for managing Enel's Property Claims Management Program. ... to verbalize in clear concise and tactful communication with senior executive management, clients, peers and team members; Strong...policies. #li-kd1 2560987 Aon is looking for a Property Claims Specialist to fill a virtual role!… 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
- Baystate Health (Springfield, MA)
- **Summary:** Under the direction of the Chief Risk Officer, the Sr Director of Clinical Safety and Risk Management is responsible for the effective operation of the ... Risk Management Department of Baystate Health. The Sr Director of Clinical Safety and Risk Management assists...Clinical Safety and Risk Management also collaborates with the Claims Managers in the operations of the system-wide … 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
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