- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- Medical Office Coder This is a full-time 40 hour per week position, Monday - Friday 8:30 AM - 5:00 PM Benefits: + 401K + Medical , Dental and Vision ... Assistance Program + Employee Discount Program Job Summary: The Medical Coder complies with all legal requirements...A minimum of 2-3 years experience working in a Medical office . + At least 1 year… more
- Children's Hospital Boston (Boston, MA)
- 75989BRJob Posting Title:Physician Medical Coder (Shared Service Center)Department:Shared Service CenterAutoReqId:75989BRStatus:Full-TimeStandard Hours per ... Week:40 Job Posting Category:FinanceJob Posting Description:The Physician Medical Coder will be responsible for: + Performs complex ICD-10 and CPT review and… more
- Tufts Medicine (Burlington, MA)
- …and validations of Medicare, Medicaid, Commercial HCCs and DxCG's through medical record reviews. Reviews provider documentation for ICD-10-CM codes to verify ... documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to determine if diagnostic codes (ICD-10-CM) as well as Current… more
- Commonwealth Care Alliance (Boston, MA)
- …Education:** + Bachelor's Degree or equivalent experience **Required Experience:** + CPC medical coding background + Proficiency in Microsoft Office (Word, ... **Why 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… more
- Atrius Health (Newton, MA)
- …benefit package. **Job:** **Other Allied Health* **Organization:** **Finance* **Title:** *Certified Medical Coder - Remote* **Location:** *Newton MA - Riverside* ... care for more than 690,000 adult and pediatric patients at 30 medical practice locations in eastern Massachusetts. Atrius Health's 645 physicians and primary… more
- Intermountain Health (Boston, MA)
- …continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques to support the ... internal audit reviews.12. Identifies the need to clarify documentation in the medical record and communicates with physicians using the appropriate "query" tools… more
- Commonwealth Care Alliance (Boston, MA)
- …employment -- + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education ... direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective… more
- Highmark Health (Boston, MA)
- …including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and ... ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for… more
- CenterWell (Boston, MA)
- …Education, and work as a thought partner with Coding and Documentation Improvement Medical Director. The main responsibilities of the role are: + Determine clinician ... with clinical education team and CDI (coding and documentation improvement) medical director embedded in Clinical excellence. + Align clinician coding education… more
- Commonwealth Care Alliance (Boston, MA)
- …development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical expense spending and support the execution for a comprehensive claim ... a comprehensive, strategic roadmap to recover, eliminate, and prevent unnecessary medical -expense spending by reviewing upstream and downstream processes. + Identify… more
- Tufts Medicine (Boston, MA)
- …school diploma or equivalent. 2. Two (2) years of experience in an automated medical billing and collection environment for a medical services provider and/or ... processional and technical charges. **Preferred Qualifications** **:** 1. Completion of a medical terminology course to attain understanding of CPT and ICD diagnosis… more
- Highmark Health (Boston, MA)
- …Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability to solve ... and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of… more
- Tufts Medicine (Burlington, MA)
- …routine and require analysis to understand. **Job Overview** This position reviews medical records to assure accurate specificity of diagnoses and procedures for ... diploma or equivalent. 2. Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA) or Registered Health… more
- Sharecare, Inc. (Boston, MA)
- …Manager + Radiology Technician + Home Health Aide + Occupational Therapist Aide + Medical Coder + Dental Assistant + Experience in customer service in a ... utilization management (UM) status, including but not limited to medical , dental, and vision plans + Provider search (PCP,...healthcare contact center, provider office , or healthcare institution + Experience in successful resolution… more
- Elevance Health (Woburn, MA)
- …SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office ). The ideal candidate will live within 50 miles of one of our Elevance ... Health PulsePoint locations. **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues… more
- Elevance Health (Woburn, MA)
- …Investigator II** **Location: This position will work in a hybrid model (remote and office ). The ideal candidate must live within 50 miles of our Elevance Health ... + Review and conducts analysis of claims and dental medical records as related prior to payment. + Research...in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years… more
- Elevance Health (Woburn, MA)
- …line of business** _Location: This position will work a hybrid model (remote and office ). The ideal candidate will live within 50 miles from our Elevance Health ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **RN Hospital Audit/Appeal Lead** is responsible for… more
- Elevance Health (Manchester, NH)
- …Validation Auditor** **Location:** This position will work a hybrid model (remote and office ). Ideal candidates will live within 50 miles of one of our PulsePoint ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
- Medtronic (Boston, MA)
- …we serve. Make your impact by exploring a career with the world's leading Medical Device company, striving "to alleviate pain, restore health, and extend life." As a ... for commercial products, preferably in regulated industries + Experience with medical product development is highly desired, including knowledge of regulatory… more
- Children's Hospital Boston (Boston, MA)
- …experience within a hospital or healthcare billing setting + Certified Professional Coder + Knowledgeable in revenue cycle operations + Familiar with insurance ... operations + Ability to train new staff with limited insurance knowledge on medical insurance + System proficiency with Epic, Powerchart, QCC, 3rd party insurance… more