- Humana (Boston, MA)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… 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
- Abt Global Inc. (Cambridge, MA)
- …career and their experience conducting research on post-acute care , nursing home health care policy, and health care claims data to play key technical ... homes or other post-acute care settings, health care policy. + Use Medicare claims data...Abt Global will never ask candidates for money in exchange for an offer of employment. _ _\#LI-CO1_ #LI- Remote … more
- RTX Corporation (Boston, MA)
- Date Posted: 2025-01-31 Country: United States of America Location: RMA99: RTN Remote , Massachusetts Position Role Type: Remote At Raytheon, the foundation of ... Chain (SC) Legal Advisor, who will report to the Associate Director, Raytheon SC Advising. The SC Advisor provides...Review and advise SC on performance issues such as claims and insolvency. + Assist the organization in writing… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Senior Physician Billing Associate (Shared Service Center - Westwood)Department:Shared Service CenterAutoReqId:76198BRStatus:Full-TimeStandard ... per Week:40 Job Posting Category:AdministrationJob Posting Description:Location/Schedule: Westwood, MA. Hybrid/ Remote - 1 day/week in office after completion of… more
- Takeda Pharmaceuticals (Lexington, MA)
- …is true to the best of my knowledge. **Job Description** ** Associate Director, US Advertising & Promotion Regulatory Review** **Takeda Pharmaceutical** **Lexington, ... MA or Exton, PA** **About the role:** Join Takeda as an Associate Director, US Advertising & Promotion Regulatory Review out of our Lexington, MA or Exton, PA… more
- LogixHealth (Bedford, MA)
- Location: Bedford, MA; Remote in AL, FL, GA, MI, MO, NC, NH, OH, OK, TN, TX, WI, and, WV This Role: Manage and ensure timely enrollment of client groups and ... and monitor contract termination dates and make sure that claims are processed based on the contracted rates. Key...that allow physicians to focus on providing great clinical care . LogixHealth was founded in the 1990s by physicians… more
- Takeda Pharmaceuticals (Cambridge, MA)
- …with a focus on products sold through Institutional Health Systems. The Associate Director, Institutional Analytics and Forecasting will be accountable for being a ... serving as an expert business advisor to the Institutional Care franchise team of PDT, you will also be...dispense data, Biological Distributor data, and Symphony or Komodo claims required. + Proficiency in Tableau or other data… more
- Takeda Pharmaceuticals (Lexington, MA)
- …true to the best of my knowledge. **Job Description** Join Takeda as an Associate Director, IBD Analytics out of our Lexington, MA office. This role involves leading ... understanding of end-to-end data architecture, industry-standard secondary data (eg claims data), and analytics models **Minimum Requirements/Qualifications:** + Bachelor's… more
- WellSense (Boston, MA)
- …**Preferred/Desirable:** + Knowledge of medical terminology a plus + Knowledge of care management software systems, claims systems (preferably Facets) for ... Care Coordinator WellSense Health Plan is a nonprofit...duties as requested. Our Investment in You: + Full-time remote work + Competitive salaries + Excellent benefits **Key… more
- Humana (Boston, MA)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes,...**What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …preferred) + Credentialed coder (CPC, CCS) required + Minimum 3-5 years acute care experience #LI- REMOTE Minimum Education Requirements: High school degree or ... RoleThe Appeals Nurse Reviewer is responsible for reviewing provider claims appeals, validating coding and medical necessity of the...and that work/life balance is a key part of associate wellbeing. For more information on how we work… more
- Children's Hospital Boston (Boston, MA)
- …TechnologyJob Posting Description: This IT Epic Analyst II - Professional Billing and Claims will be responsible for: + Serves as a team resource in (Professional ... Group Meeting). In order to qualify, you must have: + Bachelor's Degree OR An Associate 's Degree with an additional 2 years of related experience or a high school… more
- Humana (Boston, MA)
- …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( 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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …member's eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and external clients via ... Process pharmacy authorizations utilizing PBM real time on line claims adjudication software. + Support new clinical program implementation...issued laptop home and work from home or other remote location in the event of a building closure,… more
- Amgen (Boston, MA)
- …in the public or private third-party access arena or pharmaceutical industry in managed care , clinical support, and/or sales OR Associate degree AND 10 years of ... insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate offices using approved materials + Review… more
- Humana (Boston, MA)
- …first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position \#LI- Remote **Scheduled Weekly Hours** 40… more
- Harvard University (Cambridge, MA)
- 67716BRAuto req ID:67716BRJob Code:400110 Financial Associate I Department Office Location:USA - MA - Cambridge Business Title:Assistant Manager, Card ... Monitors losses due to disputes and fraud, including bond claims . + Manages digital communications, ensuring quality and accuracy...of paid leave for new parents who are primary care givers. + Health and Welfare: Comprehensive medical, dental,… more
- LogixHealth (Bedford, MA)
- Location: Bedford, Ma; Hybrid; Remote in AL, FL, GA, MA, MI, MO, NC, NH, OH, OK, TN, TX, WI, WV This Role: The purpose of the Application Specialist in Billing ... Apps + Microsoft certifications preferred + Modern Desktop Administrator Associate Enterprise Administrator Expert, Azure Fundamentals (AZ-900) + Azure Administrator… more
- Children's Hospital Boston (Boston, MA)
- …or BCH offerings. To qualify you must have: + Bachelor's Degree or An Associate 's Degree with an additional 2 years of related experience or a high school ... and integrations is preferred + Professional billing or Professional billing claims EPIC certification is required Boston Children's Hospital offers competitive… more