Medicare Supervisor Claims Reviewer - Somerville, MA

Responsible for overseeing a team of claims reviewers to ensure accurate and timely healthcare claims processing. · -Supervise and manage a team of claims reviewers to ensure accurate and timely healthcare claims processing. · -Oversee claims review and analysis to ensure compl ...

Responsible for overseeing a team of 4-5 employees that assesses Medicare claims for accuracy, · compliance, · and eligibility ensuring that claims are processed efficiently · and in accordance with industry standards regulatory requirements · and organizational policies. · This ...

Responsible for overseeing a team that assesses healthcare claims for accuracy, compliance, and eligibility, · ensuring that claims are processed efficiently and in accordance with industry standards, regulatory requirements, · and organizational policies. This position will guid ...

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities. · ...

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. · Review claims to ensure accurate coding, appropriate documentation, and compliance with applicable billing regulations and payer guidelines. · ...

The Claims Operations Manager is responsible for managing commercial claims operations to ensure efficient and accurate processing of claims. Oversees claims workflows, compliance, and team performance to support revenue cycle goals and optimize reimbursement processes. · ...

+We are seeking a highly organized and detail-oriented individual to join our team as a Billing Specialist.The ideal candidate will have strong communication skills, a customer service mindset, and the ability to work independently in a fast-paced environment. · This is an opport ...

The Payment Policy Manager is vital to the team responsible for developing implementing and managing payment policies strategies by analyzing regulatory changes reimbursement models optimize revenue ensure compliance federal state payer specific guidelines. · This role complement ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department. Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · For n ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department. Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · For n ...

Join a fast-growing company as a Claims Representative and review process simple and straightforward Commercial claims within assigned authority limits consistent with policy and legal requirements. · Investigates claim using internal and external resources including speaking wit ...

Job Summary · The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical re ...

The Insurance Support Nurse participates in the timely management of denials that are received in the Care Coordination Department.Through sound knowledge of utilization management, the nurse is able to assess a patient's level of care after review of the medical record. · ...

This role involves extracting knowledge and insights from data to investigate business/operational problems using various techniques. Key responsibilities include collecting and analyzing Medicare Advantage claims data to ensure timeliness accuracy compliance; reviewing tracking ...

MWHis currently seeking a Project Engineer to support both preconstruction and construction efforts on critical water, wastewater, · and advanced water treatment plant projects based out of Somerville MA metropolitan area. · ...

Mass General Brigham relies on a wide range of professionals to advance its mission. The Fraud Analyst builds data analytics for MGB Health Plan's Special Investigations Unit; this role uses data analytics for the SIU to find fraud leads. · Job Summary · The role will create anal ...

The Collections Representative is responsible for communicating with patients, · insurance companies, and other parties to collect outstanding balances, · resolve billing disputes, and ensure proper reimbursement for the hospital.Monitor · & manage the accounts receivable of the ...

Mass General Brigham relies on a wide range of professionals to advance its mission. As a Clinical Review Specialist, you will facilitate accurate identification of patient medical conditions through comprehensive chart review. You will utilize clinical and coding knowledge to in ...

We are hiring a Collections Representative to communicate with patients, insurance companies, and other parties to collect outstanding balances, resolve billing disputes, and ensure proper reimbursement for the hospital. · High School Diploma or Equivalent required · Associate's ...