- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve ... fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of...and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,… more
- KPMG (Boston, MA)
- **Business Title:** Manager, Commercial Contracts- Audit **Requisition Number:** 116976 - 40 **Function:** Business Support Services **Area of Interest:** **State:** ... for being a great place to work and build a career, KPMG provides audit , tax and advisory services for organizations in today's most important industries. Our growth… more
- LogixHealth (Bedford, MA)
- …relationships and maintains open communication with third party payor representatives to resolve claims issues + Review / Audit insurance credit balance for ... contribute to our fast-paced, collaborative environment and will bring your expertise to review and audit processing, posting, refunds and adjustments for all… more
- Walgreens (Chelmsford, MA)
- …patient issues and prevent payment rejections. Follows up with insurance companies and medical providers and participates in 3rd-party audit . + Follow-up with ... outcomes services. Responsible for ensuring the proper compounding, dispensation, review , and verification of prescribed medications within regulatory guidelines,… more
- Walgreens (Woburn, MA)
- …issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines,… more
- Walgreens (Malden, MA)
- …issues and prevent payment rejections. Follows- up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines,… more
- Bank of America (Boston, MA)
- …and Dodd-Frank Act, and other applicable federal/state laws, including claims of retaliation, fraud, and regulatory/compliance violations. **RESPONSIBILITIES:** + ... and pending employment litigation matters. + Partner with Human Resources, Compliance, Risk, Audit , and other control functions of the Bank to provide guidance on… more
- RTX Corporation (Tewksbury, MA)
- …provides advice and drafting support for purchasing professionals and will: review purchase order/subcontract terms and conditions in compliance with applicable ... assist in negotiations regarding deviations from standard provisions. + Review and advise SC on performance issues such as... and advise SC on performance issues such as claims and insolvency. + Assist the organization in writing… more
- Amentum (Boston, MA)
- …and ongoing management of benefit vendors and consultants; + Assists with the review of benefit documentation such as original and amended plan texts, benefit ... + Develop and distribute reports such as benefits utilization, trend analysis, claims , fees, and provider performance evaluations + Assists in administration of… more
- Cardinal Health (Boston, MA)
- …and pharmacy insurance benefit practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience preferred + 1-2 years ... notations for every interaction using the appropriate database for the inquiry + Self- audit intake activities to ensure accuracy and efficiency for the program +… more
- Cardinal Health (Boston, MA)
- …and pharmacy insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years experience ... notations for every interaction using the appropriate database for the inquiry * Self- audit intake activities to ensure accuracy and efficiency for the program *… more
- Takeda Pharmaceuticals (Boston, MA)
- …support to Local Affiliates for responses to health authorities requests, review of local labeling exceptions and alignment deferrals, etc. Escalation Process ... at the Labeling cross functional teams including clinical, safety, medical affairs, and commercial, to ensure the highest level...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …state courts and in administrative hearings concerning a wide variety of legal claims . The attorney will also interact with other business areas to effectuate ... of a team of senior managers, data analysts, fraud investigators, certified coders and medical providers. + Manage strategy, goal setting and budget for the FIP Unit… more
- Walgreens (Arlington, MA)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... insurance companies as well as medical providers and conducts or participates in 3rd party audit . + Assists and supports Store Manager and Pharmacy Manager in… more
- Robert Half Finance & Accounting (Dedham, MA)
- …schedules and reports. - Serve as a primary or secondary contact for site-specific claims review and processing. - Manage escrow accounts, ensuring deposits are ... Strong Managerial experience + CPA license preferred. + Experience coordinating audit activities and managing reporting, budget development and analysis, accounts… more