• Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding … more
    Commonwealth Care Alliance (05/28/25)
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  • Senior Special Investigations Coding…

    CVS Health (Boston, MA)
    …+ Leadership: Leads a team of coding /nursing professionals who conduct reviews of medical records and claims for suspected healthcare fraud, waste, and ... Skills: + Minimum of 8 years of experience in medical coding in an SIU setting with...Nurse (RN) Licensure preferred + Experience conducting audits of medical records to substantiate allegations of healthcare … more
    CVS Health (05/24/25)
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  • Coding Auditor Educator

    Highmark Health (Boston, MA)
    …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
    Highmark Health (05/09/25)
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  • Resource Assistant, Coding

    LogixHealth (Bedford, MA)
    …Diploma or equivalent combination of education and experience required 2. Baseline knowledge of medical coding or currently in a certification program is a plus ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
    LogixHealth (05/05/25)
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  • Senior Administrative Lead, Coding

    LogixHealth (Bedford, MA)
    …ien ce: Priorex pe r ie nce an dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification is a plus. Spe cificJ ob ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
    LogixHealth (05/05/25)
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  • Medical Coding Specialist

    LogixHealth (Bedford, MA)
    …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... /facility coder production, other specialties and consistently meet LogixHealth coding industry standards + Monitor and track use of...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
    LogixHealth (05/05/25)
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  • Senior Software Engineer- COBOL coding

    Humana (Boston, MA)
    … claims processing and management solutions. This position involves coding software applications based on business requirements and addressing moderately complex ... a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential...in computer science or a related field. + COBOL coding experience. + 5 or more years of experience… more
    Humana (05/16/25)
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  • Medical Claims Follow-Up…

    Atrius Health (Chelmsford, MA)
    …benefit package. **Job:** **Accounting/Billing/Finance* **Organization:** **Finance* **Title:** * Medical Claims Follow-Up Representative* **Location:** ... responsible for the follow up and resolution of denied medical billing claims for assigned payer(s). In...claim forms, fundamental knowledge of HCPCS, ICD10 and CPT coding required. * Knowledge and experience with medical… more
    Atrius Health (05/22/25)
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  • Claims Specialist, Audit & Contracting

    LogixHealth (Bedford, MA)
    …Excel, and Outlook Preferred: + One to two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We ... revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting… more
    LogixHealth (04/11/25)
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  • Healthcare Follow Up - Facility (Remote)

    Cognizant (Boston, MA)
    ** Healthcare Follow Up - Facility** Cognizant is one of the world's leading professional services companies, we help our clients modernize technology, reinvent ... payer denials, experience in identifying procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and… more
    Cognizant (05/13/25)
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