- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 ... guidelines, claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding … more
- Commonwealth Care Alliance (Boston, MA)
- …in both medical and administrative cost savings. + Manage the day-to-day financial recovery vendor relationships, validating that identified overpayments are ... the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery ...and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for … more
- Sedgwick (Boston, MA)
- …maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to ... meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your… more
- Sedgwick (Boston, MA)
- …maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to ... meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your… more
- Elevance Health (Woburn, MA)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and procedures. +… more