- 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
- 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
- Prime Therapeutics (Boston, MA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Customer Care Associate I - Remote **Job Description Summary** This position is ... Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities… 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
- Firefly Health (Watertown, MA)
- …members with questions regarding the Firefly Health Plan; Provider network, claims , benefits, medications, prior authorizations, Care -Key requirements, & ... is building a revolutionary new type of comprehensive health " care and coverage," powered by a relationship-driven care...members throughout the referral process + Review and compare claims and data in order to resolve member and… 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
- 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
- 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
- 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
- Humana (Boston, MA)
- …operational efficiency, reduce manual processes, and improve accuracy in insurance claims processing, policy management, and other key areas. A strong background ... solutions to streamline and automate insurance-related processes, such as claims processing, policy administration, and customer service operations. + **Technical… more
- Tufts Medicine (Tyngsboro, MA)
- …(Tyngsborough during onsite work), with potential option to migrate to fully remote . **Job Profile** **Summary** This role focuses on activities related to revenue ... duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted … more
- Humana (Boston, MA)
- …for an experienced medical coding auditor to (suggest: review inpatient hospital claims for proper reimbursement) handle provider disputes in a result-oriented and ... payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments....**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Harvard University (Cambridge, MA)
- …comprehensive policy research and education. Under the direction of Dr. Zirui Song, Associate Professor of Health Care Policy and Medicine, the Research ... + Must demonstrate interest, experience, or background in health care research. + Must be proficient with most computer...software to work with large data sets, including insurance claims datasets. This work will involve creating and managing… more
- Humana (Boston, MA)
- …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… 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)
- …must have an active compact (Multistate) license and experience in Behavioral Health. #LI- Remote This is a Full-Time, Remote Telephonic RN opportunity, however ... Assess discharge plans + Review and extract information from claims + Complete documentation for Quality Reviews for Peer...to make an impact** **Required Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse (RN) licensure… more