- Prime Therapeutics (Boston, MA)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Appeals Coordinator **Job Description** + Maintains a caseload and monitors day to ... medical necessity reviews. + Enters all data related to appeals and case reviews into a database. + Prepares...into a database. + Prepares and presents information on appeals to panels second-level multi-disciplinary committee. + Participates in… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Appeals and Grievance (A&G) Coordinator is responsible, per State and ... Federal regulations, for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health. Responsibilities include, but are… more
- Cardinal Health (Boston, MA)
- …to Cardinal Health_** The Sr. Coord, Individualized Care (Reimbursement Coordinator ) supports patient access to therapy through Reimbursement Support Services ... * Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
- Danaher Corporation (Waltham, MA)
- …so we can truly drive science forward. The Senior Quality Assurance Coordinator is responsible for distributing, tracking and managing the controlled quality ... essential for this role with the ability to write clearly, succinctly in a manner that appeals to a wide audience. It would be a plus if you also possess previous… more
- Cardinal Health (Boston, MA)
- …documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Knowledge of Medicare, Medicaid and Commercially insured ... payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of Medical/Pharmacy billing and coding is preferred + Important to… more
- Cardinal Health (Boston, MA)
- …Events and follow process for timely submission. Review all requests for appeals and ensure supporting documentation is present. Support team with call overflow ... when needed. Ability to mediate situations in which parties are in disagreement and facilitate a positive outcome. Effectively be able to multitask daily tasks and workload. + **TRAINING AND WORK SCHEDULES** : Your new hire training will take place… more
- State of Massachusetts (Boston, MA)
- …The Executive Assistant will supervise the Docket Clerk in the Hearing and Appeals Unit. *Duties and Responsibilities:*(these duties are a general summary and not ... the Office of the General Counsel EPRS (Employee Performance Review System) Coordinator .* * Coordinate and review with supervisors and reviewers all EPRS… more
- Brockton Hospital (Brockton, MA)
- …rounds. Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as a change agent ... agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to… more