- Lincoln Financial Group (Boston, MA)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- BrightSpring Health Services (Taunton, MA)
- …need. + Be a vital part of a team that's dedicated to enhancing patient care through meticulous claims management and customer service. What We Offer: + DailyPay ... PharMerica Overview Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make...you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical support… more
- Commonwealth Care Alliance (Boston, MA)
- …This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special ... and other CCA departments related to review processes and results. Sr Associate , FWA Investigator Coder utilizes claim analysis, document review, coding knowledge… more
- Humana (Boston, MA)
- …determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage all aspects of a ... **What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company...opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent… more
- Takeda Pharmaceuticals (Boston, MA)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Commonwealth Care Alliance (Boston, MA)
- …Commonwealth Care Alliance (CCA) pharmacy program. Operational functions include: claims oversight and resolution, monthly EOB reviews and monthly formulary and ... adapt to a dynamic environment. **What You'll Be Doing:** ** CLAIMS OVERSIGHT** + Daily reject and paid claims...the department. **What We're Looking For:** **Required Education:** + Associate degree in Healthcare, Nursing, Pharmacy or a related… more
- Commonwealth Care Alliance (Boston, MA)
- …across the enterprise including Clinical Analytics, Utilization Management, Clinical Automation, Claims and Encounters Processing and driving our strategic Model of ... Care . **Supervision Exercised:** + No, this position does not...monitoring, and maintenance of AI-driven systems. **Working Conditions:** + Remote + Preferred ability to commute distance to Boston,… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Senior Physician Billing Associate (Shared Service Center - Westwood)Department:Shared Service CenterAutoReqId:75985BRStatus:Full-TimeStandard ... Hours per Week:40 Job Posting Category:FinanceJob Posting Description:Hybrid/ Remote - 1 day a week in office at...in office at Westwood location The Senior Physician Billing Associate shall be responsible for: + Reviewing and verifying… more
- RTX Corporation (Andover, MA)
- …BBN team: Brief Department Description We have an opening for an Associate Director, Risk Management & Insurance in Raytheon Technologies (RTX) Treasury department ... role can be Hybrid based in either Boston Area or NYC area or full remote based on the eastern seaboard and is responsible for partnering with RTX business segments… more
- Takeda Pharmaceuticals (Lexington, MA)
- …true to the best of my knowledge. **Job Description** Join Takeda as an Associate Director, US Advertising & Promotion Regulatory Review out of our Lexington, MA or ... + Provide product development and label development strategies to ensure promotional claims can be supported. + May provide management of individuals including… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Physician Billing Associate (Westwood, Mon-Fri, 10a-2p, Onsite)Department:Shared Service CenterAutoReqId:75467BRStatus:Part-TimeStandard Hours ... Monday - Friday, 10:00a - 2:00p Location: Westwood, MA This Physician Billing Associate will be responsible for: + Deliver an exceptional experience to every… more
- J&J Family of Companies (Boston, MA)
- Associate Director, Signal Detection Scientist - 2406212640W **Description** Johnson and Johnson is currently seeking an ** Associate Director, Signal Detection ... NJ; Raritan, NJ; Horsham, PA; OR High Wycombe, UK. Remote work options in the US or UK may...international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and… more
- Surgery Care Affiliates (Waltham, MA)
- Overview Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of ... patient care . Together, our teammates create value in specialty ...growing career opportunities for YOU. ** This is a REMOTE position. ** Responsibilities Specifically, you will work in… more
- BrightSpring Health Services (Taunton, MA)
- …PharMerica Overview Our Point of Sale Adjudicators are crucial to our 3rd Part Claims activities and our business. This is an excellent opportunity to move from a ... pharmacy to office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or knowledge of… more
- Humana (Boston, MA)
- …health first** Humana's Clinical Analytics Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
- Humana (Boston, MA)
- …put health first** Business Intelligence Engineers on the Provider Intelligence and Claims Analytics (PICA) team solve complex business problems and issues using ... of action. About Our Team The Provider Intelligence and Claims Analytics (PICA) team is a blend of experts...business outcomes and decisions **Additional Information** This role is " remote /work at home" and can be based anywhere in… more
- Humana (Boston, MA)
- …objective evaluation of physician performance related to our two key metrics: Efficiency of Care (cost) & Effectiveness of Care (quality). Humana is seeking a ... understanding of physician networks, physician performance and rating metrics ( claims , measures, conditions, specialties, etc.), product offerings, and analytics-based… more
- NASCO (Boston, MA)
- …and system issues, plus research and resolution of Model Office and Production issues so claims can be paid accurately and timely + Provides support to NASCO and the ... others being over the phone. (required if person is remote ) + Minimum 8 years of proven experience in...mentoring System Engineers. + In-Depth knowledge of the Health Care industry + Extensive working knowledge of and capabilities… more
- South Middlesex Opportunity Council (Framingham, MA)
- …process. + Work closely with medical staff to ensure effective coordination of care . + Work closely with billing team to ensure clinical providers meet billing ... as required by payors and state agencies. Monitor weekly claims reports and assist in correcting billing issues. +...assist in correcting billing issues. + Continuously improve client care by monitoring access to care and… more
- Humana (Boston, MA)
- …Science, finance, Statistics, Economics or related field + Experience working with Claims , Billing and Reconciliation or related healthcare data + Expertise in ... and Root Cause Analysis (RCA) experience **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this… more