• Payment Integrity Coding

    Humana (Boston, MA)
    **Become a part of our caring community and help us put health first** The Payment Integrity Coding Professional within Code Edit Vendor Management ... of situations or data requires an in-depth evaluation of variable factors. The Payment Integrity Coding Professional monitors and analyzes Code Edit… more
    Humana (12/18/25)
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  • Payment Integrity Clinician

    Highmark Health (Boston, MA)
    …consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in ... The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment...coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the… more
    Highmark Health (11/14/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …make recommendations based on new/revised coding edits for presentation to Payment Integrity committee meetings. + Analyze, measure, manage, and report ... certified within 1 year of employment - + Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) +...programs and reimbursement methodologies (Medicaid and Medicare) + Medical Coding , Compliance, Payment Integrity and… more
    Commonwealth Care Alliance (11/25/25)
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  • IT Quality Assurance Analyst - Contract Role (AN)

    Nelnet (Boston, MA)
    …a professional services company, consumer loan originator and servicer, payment processor, renewable energy innovator, and K-12 and higher education expert (and ... lives through the power of service as a student loan servicer, professional services company, consumer loan originator and servicer, payments processor, renewable… more
    Nelnet (12/03/25)
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