• Medicare / Medicaid Claims…

    Commonwealth Care Alliance (Boston, MA)
    …and medical coding (CPT, HCPCS, Modifiers) along with the application of Medicare /Massachusetts Medicaid claims ' processing policies, coding principals and ... ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role...Management + Collaborate system and data configuration into CES ( Claims Editing System) with BPaaS vendor and… more
    Commonwealth Care Alliance (11/25/25)
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  • Payment Integrity Coding Professional

    Humana (Boston, MA)
    …by reading and interpreting claims + Exceptional understanding of Centers for Medicare & Medicaid Services (CMS) guidelines, state Medicaid guidelines, ... (CEVM) contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
    Humana (12/18/25)
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