- Sedgwick (Boston, MA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
- Ryder System (Boston, MA)
- …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… 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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to resolve telephone and written dental provider eligibility, benefit and claims -related inquiries in a fast pace, results driven, inbound call center. ... and dental policies and guidelines, timely filing, account receivables, and claims processing. The Dental Provider Service Representatives will represent the Dental… more
- Prime Therapeutics (Boston, MA)
- …decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting ... levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team +...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- United Therapeutics (Boston, MA)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
- State of Massachusetts (Boston, MA)
- …/* _Division Chief_ _Health Care & Fair Competition Bureau_ _False Claims Division_ Attorney General Andrea Joy Campbell is looking for an ... her management team as the Chief of the False Claims Division. The False Claims Division investigates...Type_: Full Time/Exempt. Our current hybrid model includes some remote workdays for most positions. _Salary_: $137,417 *_To apply… more
- HealthEdge Software Inc (Boston, MA)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Boston, MA)
- …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
- HealthEdge Software Inc (Boston, MA)
- …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Boston, MA)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more