- CVS Health (Boston, MA)
- …- Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for ... handle customer service inquiries and problems. **Additional Responsibilities** - Reviews pre-specified claims or claims that exceed specialist adjudication… more
- CVS Health (Boston, MA)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Collaborate with insurance companies when necessary to proactively validate benefits , eligibility, and referral requirements. Communicate with patients to ensure ... and leadership for approval to proceed or reschedule. + Verifies covered benefits , including remaining hospital days, carve out coverages, and benefit … more
- Zurich NA (Boston, MA)
- …New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, or Vermont. The Senior Workers Compensation Claims Specialist will handle multi-party ... Sr. Claims Specialist (Workers Compensation, NE Region)...of damages allowed by law. + Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available… more
- USAA (Boston, MA)
- …(Associate in General Insurance), CPCU (Chartered Property Casualty Underwriter), AIC (Associate in Claims ), or SCLA ( Senior Claims Law Associate) or ... accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and ... to enhance provider satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account… more
- Cardinal Health (Boston, MA)
- …authorization through billing and collections. Job Purpose: The Patient AR Specialist is responsible for managing and resolving outstanding patient balances, ... and/or billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits … more
- Medtronic (Boston, MA)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more
- Philips (Cambridge, MA)
- …important member of the Philips North America MRI Clinical Science team, the Senior MRI Clinical Scientist will collaborate with medical doctors and physicists of ... in North America. + Will be the expert MRI specialist in an assigned technical or clinical application area,...IP for product development and generate evidence to support claims through scientific publications. + Be hands-on, be able… more
- Adecco US, Inc. (Boston, MA)
- …life insurance, short-term disability, additional voluntary benefits , EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees ... detail-oriented Executive Assistant & Program Coordinator to support four senior executives spearheading a major multi-year Technology Enabled Business… more