- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Reviewer is responsible for reviewing provider claims appeals, validating coding and medical necessity of the services submitted and pricing the claims according to ... appropriate guidelines. This position requires strong clinical and medical coding skills to review provider claim appeals for medical necessity, appropriate… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Certified Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education (nice ... the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for.... Center for Medicare & Medicaid Services (CMS) & MA Medicaid, Correct Coding Initiative (CCI), Medically Unlikely Edits… more
- Highmark Health (Boston, MA)
- …and/or coding and billing **LICENSES or CERTIFICATIONS** **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Risk Coder ... its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage ( MA ) and Affordable Care Act (ACA), using skills including but not limited… more
- Brockton Hospital (West Bridgewater, MA)
- …+ Certification/Licensure: Requires Certified Coding Specialists (CCS) or Certified Professional Coder (CPC) or Registered Health Information Technician ... is Southeastern Massachusetts' premier local provider of quality, personalized medical services. We are comprised of the award-winning not-for-profit Signature… more
- Takeda Pharmaceuticals (Boston, MA)
- …+ Experience working with cross functional teams (eg, Data Manager, Clinical Science, Medical Coder ) + Experience with SQL and data manipulation. + Knowledge ... us as a Senior Manager, Clinical Data Visualization Engineer in our Cambridge, MA office. At Takeda, we are transforming the pharmaceutical industry through our… more