- Staffing Now (Boston, MA)
- Pharmacy Operations Specialist temporary position. Duties: Review daily reject and paid claims to ensure proper adjudication. Daily and monthly transition ... review, identify systemic issue with configuration and resolve issues in a timely manner. Create, maintain, submit and post formularies using formulary management tools. Monthly review of EOBs to ensure accuracy of information. Review pharmacy directories to… more
- Staffing Now (Boston, MA)
- … Specialist temporary positionDuties: Review daily reject and paid claims to ensure proper adjudicationDaily and monthly transition review, identify systemic ... issue with configuration and resolve issues in a timely mannerCreate, maintain, submit and post formularies using formulary management toolsMonthly review of EOBs to ensure accuracy of informationReview pharmacy directories to ensure accuracy of data to… more
- Staffing Now (Bedford, MA)
- Billing Specialist temporary to hire for a large coding and billing client located in Bedford Ma. Duties: Review accounts receivable reports follow up on unpaid ... claims , work denials on an explanation of benefits statement,...out appeals, submit required documentation to insurance companies, research claims for information to process on a timely manner,… more
- BrightSpring Health Services (Taunton, MA)
- Our Company PharMerica Overview Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? ... Join our PharMerica team as a Claims Specialist , where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical… more
- Sedgwick (Boston, MA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist Professional Liability, Public Entity **PRIMARY PURPOSE** **:** ... entity; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices… more
- Lincoln Financial Group (Boston, MA)
- …73468 **The Role at a Glance** We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization. As a ... administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop… more
- Lincoln Financial Group (Boston, MA)
- …**The Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist ** to support our ever-growing claims organization in a work ... support our west coast employer groups. _Background details_ As a Group Claims Specialist , you will support our Short Term Disability or Integrated Absence… more
- 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 ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...and respond to carrier and/or arbitrator inquires + Submit claims through state arbitration portals Qualifications : To perform… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist in EDI at LogixHealth, you will perform general tasks in the EDI Department on the Billing ... a desire to learn. Key Responsibilities: + Print paper claims for all Allscripts databases + Work daily custom...for client specific issues + Void and re-enter paper claims in Allscripts Qualifications: To perform this job successfully,… more
- Humana (Boston, MA)
- …a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 for the Financial ... claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical...CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding Coordinator 2 + Maintains required… more
- Crawford & Company (Boston, MA)
- Excellence In Everything We Touch Position Summary The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key ... areas of edjuster's content claims handling operations: + Acting/operating as a third party,...Focusing on the accurate and timely processing of content claims , via the use of edjuster's claims … more
- Trustmark (Boston, MA)
- …colleagues, clients and communities. Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and ... Critical Care. **Key Accounabilities:** + Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and… more
- USAA (Boston, MA)
- …makes us so special! **The Opportunity** We are seeking a dedicated Property Adjuster Specialist to join our field Team. The adjuster has to be located or willing ... to the area of **Boston, MA** . As a Insurance Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate,… more
- Tufts Medicine (Burlington, MA)
- …responsibilities may be assigned. 1. Serves as an experienced business specialist and technology generalist responsible for aligning technology solutions with ... business needs per the strategic direction set forth by leadership and key stakeholders. 2. Develops detailed understanding of application functionality by attending training and/or reading documentation. 3. Serves as an intermediary between internal groups… more
- Beth Israel Lahey Health (Burlington, MA)
- …not just taking a job, you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims , aged claims and denied ... resolve denials to uncover root cause and accurately appeal claims to ensure successful initial submission. The Billing ...claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review… more
- Beth Israel Lahey Health (Danvers, MA)
- …not just taking a job, you're making a difference in people's lives.** The Billing Specialist role specializes in high dollar claims , aged claims and denied ... resolve denials to uncover root cause and accurately appeal claims to ensure successful initial submission. The Billing ...claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Pharmacy Operations Specialist is responsible for supporting the operational functions of Commonwealth Care Alliance (CCA) ... pharmacy program. Operational functions include: claims oversight and resolution, monthly EOB reviews and monthly...adapt to a dynamic environment. **What You'll Be Doing:** ** CLAIMS OVERSIGHT** + Daily reject and paid claims… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …Department: Patient Accounts All Locations: East Boston Position Summary: The Billing Specialist II is responsible for organizing work flow to complete the timely ... and accurate submission of medical and dental claims to Medicaid, Medicare, other third party payors and...and maintain a low backlog of work. The billing specialist III works as part of a team that… more
- Sedgwick (Boston, MA)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor successful ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… more
- Beth Israel Lahey Health (Burlington, MA)
- …just taking a job, you're making a difference in people's lives.** The Denial Specialist I role is vital to ensure that hospital denied accounts are thoroughly ... for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement. The role also includes...that impacts the resolution of current or potential future claims . 4. Maintains open communication with third party payor… more
