• Liability Claims Representative

    Sedgwick (Boston, MA)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
    Sedgwick (10/31/24)
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  • Claims Representative I…

    Ryder System (Boston, MA)
    …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
    Ryder System (01/15/25)
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  • Pharmacy Claims Representative

    Humana (Boston, MA)
    …a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support ... & LTC hospice patients and reconcile historic billing issues. **Location: Remote US** **Shift: Monday-Friday 2:30pm-11pm EST. Flexibility to work alternating… more
    Humana (01/15/25)
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  • Sr Data and Reporting Analyst - Remote

    Prime Therapeutics (Boston, MA)
    …decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting ... levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team +...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
    Prime Therapeutics (01/16/25)
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  • Director, Senior Counsel, Regulatory & Compliance…

    United Therapeutics (Boston, MA)
    …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
    United Therapeutics (12/14/24)
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  • Division Chief

    State of Massachusetts (Boston, MA)
    …/* _Division Chief_ _Health Care & Fair Competition Bureau_ _False Claims Division_ Attorney General Andrea Joy Campbell is looking for an ... her management team as the Chief of the False Claims Division. The False Claims Division investigates...Type_: Full Time/Exempt. Our current hybrid model includes some remote workdays for most positions. _Salary_: $137,417 *_To apply… more
    State of Massachusetts (01/08/25)
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  • Senior Payment Integrity Analyst

    HealthEdge Software Inc (Boston, MA)
    …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
    HealthEdge Software Inc (01/15/25)
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  • Senior Manager, Product Operations

    HealthEdge Software Inc (Boston, MA)
    …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
    HealthEdge Software Inc (12/20/24)
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  • Business Consultant

    HealthEdge Software Inc (Boston, MA)
    …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
    HealthEdge Software Inc (12/18/24)
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  • Implementation Program Lead, Group Benefits

    Guardian Life (Boston, MA)
    …if applicable + Complimentary 1:1 financial guidance with a licensed Fidelity representative **Time Off and Remote Work** + Flexible work arrangements ... on a multi-year journey to modernize our policy administration and claims platforms to enable a best-in-class customer experience. The Implementation Program… more
    Guardian Life (11/26/24)
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  • Associate Director, Provider Enrollment

    LogixHealth (Bedford, MA)
    Location: Bedford, MA; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, and, WV This Role: Manage and ensure timely enrollment of client groups and ... individual providers and monitor contract termination dates and make sure that claims are processed based on the contracted rates. Key Responsibilities: + Assigning… more
    LogixHealth (12/30/24)
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  • Network Engineer

    HealthEdge Software Inc (Boston, MA)
    …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more
    HealthEdge Software Inc (11/27/24)
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  • Senior Principal QA Architect

    HealthEdge Software Inc (Boston, MA)
    …solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a ... permanent **Work Environment:** The physical demands described here are representative of those that must be met by an...Work across multiple time zones in a hybrid or remote work environment. + Long periods of time sitting… more
    HealthEdge Software Inc (11/20/24)
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  • Senior Quality Applications Manager

    LogixHealth (Bedford, MA)
    Location: Bedford, Ma; Hybrid; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, WV This Role: Manage and monitor projects and operations to support ... to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to perform this… more
    LogixHealth (12/14/24)
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  • Coding Specialist

    LogixHealth (Bedford, MA)
    Location: Bedford, Ma; Hybrid; Remote in AL, FL, GA, MA, MI, MO, NC, NH, OH, OK, TN, TX, WI, WV This Role: Manage and monitor projects and operations to support ... to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to perform this… more
    LogixHealth (11/05/24)
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  • Senior Provider Enrollment Specialist

    LogixHealth (Bedford, MA)
    Location: Bedford, MA; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, and WV $2500 Signing Bonus Are you interested in joining a team that strives to ... related procedures for physicians/mid/level providers to ensure groups can submit claims to insurance carriers for reimbursement. Duties and Responsibilities +… more
    LogixHealth (01/11/25)
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  • Application Specialist

    LogixHealth (Bedford, MA)
    Location: Bedford, Ma; Hybrid; Remote in AL, FL, GA, MA, MI, MO, NC, NH, OH, OK, TN, TX, WI, WV This Role: The purpose of the Application Specialist in Billing ... to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and/or ability required to perform this… more
    LogixHealth (01/11/25)
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  • Provider Enrollment Specialist

    LogixHealth (Bedford, MA)
    Location: Bedford, MA; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, and WV $2500 Signing Bonus Are you interested in joining a team that strives to ... related procedures for physicians/mid-level providers to ensure groups can submit claims to insurance carriers for reimbursement. Duties and Responsibilities +… more
    LogixHealth (12/07/24)
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  • Resource Assistant, Coding

    LogixHealth (Bedford, MA)
    Location: Bedford, Ma; Hybrid; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, WV Purpose: Provide support to the Resource Team in the delivery of an ... to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may… more
    LogixHealth (11/05/24)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Boston, MA)
    …managed care organizations, as well as state and federal employees. **WORK STYLE:** Remote /work at home with Up to 10-15% travel (local, regional, national) will be ... investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC… more
    Humana (12/19/24)
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