- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+...Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding … more
- Elevance Health (Woburn, MA)
- …locations. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Highmark Health (Boston, MA)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- LogixHealth (Bedford, MA)
- …ien ce: Priorex pe r ie nce an dpro fi c ie ncywith MS Exc el and medical background r eq uired Coding experience and/or certification is a plus. Spe cificJ ob ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- LogixHealth (Bedford, MA)
- …Diploma or equivalent combination of education and experience required 2. Baseline knowledge of medical coding or currently in a certification program is a plus ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- State of Massachusetts (Quincy, MA)
- …The Medical Coder will we responsible for providing clinical coding expertise, assuring that the ICD-10 CM/PCS (10thedition of International Classification of ... Diseases Clinical Modification/Procedure Coding System) code set, and other coding ...and Reporting. * Resolve errors associated with billing and claims processing; identify and report error patterns; and design… more
- Fallon Health (Worcester, MA)
- …from medical records. Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations Interface with other ... to this work is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar in the… more
- Humana (Boston, MA)
- …+ BS in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + Metavance and CAS ... What it takes to Succeed** + 2 years of coding certification or equivalent (Industry-recognized coding certification...from PHIA, AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement… more
- LogixHealth (Bedford, MA)
- …Preferred: + One to two years related experience + Experience with document management, medical records, or a coding background + Electronic medical record ... collaborative environment and will bring your expertise to process medical records that have been reviewed by Coders and...management services, offering a complete range of solutions, including coding and claims management and the latest… more
- LogixHealth (Bedford, MA)
- …and will bring your expertise to facilitate payment of Emergency Department Physician medical claims . The ideal candidate will have strong technical skills, ... a daily basis + Attach primary EOBs to secondary claims + Attach medical records to ...management services, offering a complete range of solutions, including coding and claims management and the latest… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Boston, MA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background,...but may not be limited to, an overview of coding practices and clinical documentation, grievance and appeals processes… more
- CVS Health (Boston, MA)
- …regulations. Stay informed about changes in the industry practices related to healthcare coding . Provide training opportunities for staff to maintain their ... healthcare fraud detection, investigation, or auditing In-depth knowledge of healthcare systems, claims processing, and regulatory requirements related to … more
- LogixHealth (Bedford, MA)
- … claims generated by staff on a daily basis + Attach primary EOBs to secondary claims + Attach medical records to claims as needed + Assist management ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Sanofi Group (Boston, MA)
- … coding , contracting, financial assistance offerings, patient support, access, medical policy and other business-related issues Neurology. In addition, they will ... patient pull though efforts. We are an innovative global healthcare company, committed to transforming the lives of people...it relates to buy & bill processes, billing and coding education, claims and adjudication by site… more
- Making Opportunity Count Inc (Fitchburg, MA)
- …operations for Reproductive Health and Behavioral Health services, ensuring accurate coding , claims submission, and reimbursement. + Ensure compliance with ... Status: Non-Exempt Union Status: None Job Level: 40 Department: Healthcare Pay Range: $30.24 to $40.91 per hour Reports...Conduct regular audits to ensure accuracy in billing and coding procedures. + Stay up to date with changes… more
- LogixHealth (Bedford, MA)
- …degree or equivalent combination of education and experience. + Overall experience in healthcare operations, medical billing and coding + Good communication ... management services, offering a complete range of solutions, including coding and claims management and the latest...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
- Highmark Health (Boston, MA)
- …through analytics and reporting solutions aligned to the Quadruple Aim of Healthcare : lower per capita health care costs, improved outcomes from and quality ... identified opportunities. This position will necessitate clinical informatics and medical knowledge. **ESSENTIAL RESPONSIBILITIES** + Leads the design, development,… more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... of education and experience require + Five years related experience in the healthcare industry in a client facing role required + Intermediate to advanced Excel… more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... of EDI operations + Prior experience with third party medical billing Benefits at LogixHealth: We offer a comprehensive...social events. About LogixHealth: At LogixHealth we provide expert coding and billing services that allow physicians to focus… more