- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Boston, MA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Boston, MA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Zurich NA (Boston, MA)
- Claims Concierge Service Executive - Northeast 127284 Zurich is looking to hire a ** Claims Concierge Service Executive** in our Claims Relationship ... business units and functional groups to execute strategies that promote claims value-added services, drive profitable growth, and improve technical excellence,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and interprets third party payments, adjustments, and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts, ... information that impacts the resolution of current or potential future claims . 3. Establishes relationships and maintains open communication with third party… more
- Highmark Health (Boston, MA)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- World Insurance Associates, LLC. (Woonsocket, RI)
- …excellent service, and professional communication + Handling renewals, service requests, claims , billing and new policies + Maintain a thorough understanding of ... markets and their appetites, underwriting guidelines, submitting and procedures + Review all applications, policies, endorsements and audits for accuracy +… more
- Ryder System (Boston, MA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- State of Massachusetts (Boston, MA)
- …work, available for work and looking for a job. The Job Service Representative I performs customer service and issue resolution by assisting employers or claimants ... information by conducting research and verifying information in order to mitigate fraud. Review and complete not 30x weekly benefit amount determinations. Review … more
- Highmark Health (Boston, MA)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (Boston, MA)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (Boston, MA)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- Beth Israel Lahey Health (Charlestown, MA)
- …back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication and ... Divisions. Provides quality customer service and serves as an exemplary representative of the Patient Financial Services team **Job Description:** **Essential Duties… more
- Fresenius Medical Center (Waltham, MA)
- …to the legal department when responding to State or Federal agency employment claims which may be filed against the organization. + Provides administrative support ... collecting data and source documents when responding to legal claims , lawsuits and subpoenas. + Reviews all field requests...issues to supervisor/manager for resolution, as deemed necessary. + Review and comply with the Code of Business Conduct… more
- Prime Therapeutics (Boston, MA)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- Fresenius Medical Center (Waltham, MA)
- …determining project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global ... the consolidation, analysis and reporting of commercial revenue. Develops standards of review and analysis to facilitate accurate and timely analysis of all… more
- Santander US (Quincy, MA)
- …**We Want to Talk to You!** **The Difference You Make** : The Specialist, Claims & Fraud Operations performs routine, analytical review of data and/or ... documentation which may include customer data and/or review for fraud/risk activities. Will play a crucial role in our operations. Your fraud analyst skills will be… more
- Weston & Sampson (Boston, MA)
- Weston & Sampson is seeking a Senior Resident Project Representative or Senior Construction Inspector for oversight and inspection of utility and infrastructure ... What you'll do: + Supervise subordinate consultant staff as appropriate. + Review contract documents and construction management requirements to identify and report… more
- National Express (Worcester, MA)
- …internal parts transfers from one location to another within multiple inventory systems. . Review repair orders with status of complete and closed for any missing or ... incorrect information that would prevent warrantable claims from being paid such as: missing Complaint/Cause/Correction comments, missing parts, or missing labor… more
- Point32Health (Canton, MA)
- …works collaboratively with the member and/or the member's authorized representative and must demonstrate superior customer service and benefit interpretation ... skills in all interactions. This individual prepares cases for presentation, discussion, review , and final disposition at the Member Appeals Committee (MAC) and… more