- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Payment Integrity Coding Professional within Code Edit Vendor Management ... of situations or data requires an in-depth evaluation of variable factors. The Payment Integrity Coding Professional monitors and analyzes Code Edit… more
- Highmark Health (Boston, MA)
- …consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in ... The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment...coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the… more
- Commonwealth Care Alliance (Boston, MA)
- …make recommendations based on new/revised coding edits for presentation to Payment Integrity committee meetings. + Analyze, measure, manage, and report ... certified within 1 year of employment - + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) +...programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding , Compliance, Payment Integrity and… more
- Humana (Boston, MA)
- …claims initially paid correctly in the system) + Minimum of 2 years Provider Payment Integrity (formally known as Financial Recovery) experience + CAS claims ... to gather knowledge on Medicare Advantage and Medicaid State Regulations + Certified Professional Coding (AAPC) + Previous experience working with the internal… more
- Nelnet (Boston, MA)
- …a professional services company, consumer loan originator and servicer, payment processor, renewable energy innovator, and K-12 and higher education expert (and ... lives through the power of service as a student loan servicer, professional services company, consumer loan originator and servicer, payments processor, renewable… more