Billing Manager - Digitech SarnovaBilling Manager - DigitechBoston, MAAdditional responsibilities include identifying deficiencies within the group and escalating them to the Director, building positive relationships both internally and externally, maintaining Key Performance Indicators (KPIs), and delivering annual reviews with staff, along with corrective actions when necessary. The A/R Management Manager is responsible for directly managing the ARM team and ensuring that outstanding accounts, denials, and appeals are accurate and followed up on in a timely manner to maximize reimbursements.
Claims Specialist Clean HarborsClaims SpecialistNorwell, MAFull timeThey communicate with policyholders, insurance agents, and other parties involved to gather necessary information and resolve any issues. Clean Harbors, Norwell, MA is looking for a Claims Specialist to join their safety conscious team!
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWaltham, MassachusettsSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Medical Malpractice Claims Specialist The Doctors CompanyMedical Malpractice Claims SpecialistBoston, MA$93,378–$122,559 / yearWe offer competitive compensation, incentive bonus plans, outstanding career opportunities, an exceptional work environment, and an impressive benefits package, which starts with medical, family and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program. This is a remote or hybrid opportunity, depending on the final candidate's location from the companys office, with the preferred location in New York, New Jersey, or New England states.
Claims Specialist Suffolk Construction Company IncClaims SpecialistBoston, MA$78,000–$106,000 / yearSuffolk - America's Contractor - is a national company with more than $9 billion in annual revenue, 3,000 employees, and 17 offices, including Boston (headquarters), New York City, Miami, West Palm Beach, Tampa, Estero, Dallas, Los Angeles, San Francisco, San Diego, Las Vegas, Herndon, U.S. Virgin Islands, and other key markets. We provide value across the entire project lifecycle through our core construction management services and complementary business lines in real estate investment, design, self-perform construction, and technology start-up investment (Suffolk Technologies).
Senior Technical Specialist, General Liability Claims Sompo International Holdings LimitedSenior Technical Specialist, General Liability ClaimsBoston, MA$115,000–$130,000 / yearEffectively represent the company's interests in meetings and negotiations; maintain a high level of claim and industry related expertise in order to assure technical competency and communicate to team members regarding significant issues and relevant changes. What you'll bring: Minimum 5 plus years' experience required in general liability claims handling with a career history of increasing responsibility with at least 3-5+ years handling excess claims, including large limit and high exposure claims.
Associate Claims Specialist Liberty Mutual Holding Company IncAssociate Claims SpecialistMAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary, during the processing of the claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate. In this role, you'll manage a caseload of routine to moderately complex claims, making key decisions on compensability, evaluating losses, and negotiating fair outcomes.
Claims Service Specialist III - Springfield and Bridgewater Offices ArbellaClaims Service Specialist III - Springfield and Bridgewater OfficesSpringfield, MassachusettsOur current reasonable and good faith estimate of the annual salary range for this position is approximately $75,000 - $78,000 based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs. Effort may concentrate around intermediate exposure, Commercial Auto, Homeowner liability, and/or Commercial Property claims among other market/line combinations with stretch assignments based on experience.
NewClaims Service Specialist IV - Commercial Lines Bodily Injury ArbellaClaims Service Specialist IV - Commercial Lines Bodily InjuryQuincy, MassachusettsOur current reasonable and good faith estimate of the annual salary range for this position is approximately $85,000 - 105,000 based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs. Interprets and evaluates medical reports to determine if they are applicable to the claim; monitors legal and medical billings and investigates for proper charges and pays accordingly.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial CorpComplex Claims Consultant/Specialist - Lawyers Professional LiabilityBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Claims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterBoston, MAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
Claims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterMAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
Claims Specialist III, Auto & General Liability American International Group Inc (AIG)Claims Specialist III, Auto & General LiabilityBoston, MA$84,000–$101,000 / yearMaintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution. Analyze and process general liability property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans.
General Liability Claims Specialist CNA Financial CorpGeneral Liability Claims SpecialistBoston, MA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Complex Claims Specialist - Professional Liability (Real Estate) CNA Financial CorpComplex Claims Specialist - Professional Liability (Real Estate)Boston, MA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Claims Specialist UNAVAILABLEClaims SpecialistBoston, MASuffolk – America’s Contractor – is a national company with more than $9 billion in annual revenue, 3,000 employees, and 17 offices, including Boston (headquarters), New York City, Miami, West Palm Beach, Tampa, Estero, Dallas, Los Angeles, San Francisco, San Diego, Las Vegas, Herndon, U.S. Virgin Islands, and other key markets. We provide value across the entire project lifecycle through our core construction management services and complementary business lines in real estate investment, design, self-perform construction, and technology start-up investment (Suffolk Technologies).
Senior Claims Specialist I Liberty Mutual Holding Company IncSenior Claims Specialist IBoston, MAResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistMARemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Senior Construction Defect Technical Claims Specialist Team Lead Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team LeadMARemote$156,000–$187,500 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Qualifications / Experience Required: A deep knowledge of construction defect claims adjudication, along with an exceptional focus on customer service, typically achieved through: A minimum of seven years' experience adjudicating construction defect claims with exposure of $100,000 or more.
ACO Medicaid Claims Review Specialist Mass General BrighamACO Medicaid Claims Review SpecialistSomerville, MassachusettsRemoteWorking with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Senior Technical Claims Specialist, Energy Complex Liberty Mutual Holding Company IncSenior Technical Claims Specialist, Energy ComplexBoston, MABachelor's degree or equivalent experience, with 5-7+ years of progressively complex Commercial Casualty claims experience, emphasizing litigated Commercial General Liability/Auto and/or Energy claims involving oil & gas, power generation, renewable energy and/or energy-adjacent contractors. Influence outcomes on high‑profile matters (operators, contractors, utilities, midstream/downstream, power generation, pipelines, offshore/onshore exposures) and work cross-functionally with underwriting, reinsurance, in-house counsel, and outside defense teams.
Claims Service Specialist I - Hybrid ArbellaClaims Service Specialist I - HybridQuincy, MassachusettsOur current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $49,010 ($26.00 an hour) - $51,008 ($27.09 an hour) based on a variety of factors including, but not limited to, relevant skills and experience, Please note: The advertised pay range is not a guarantee or promise of a specific wage. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.
ACO Medicaid Claims Review Specialist Brigham and Women's HospitalACO Medicaid Claims Review SpecialistSomerville, MARemote$17.71–$25.28 / hourWorking with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
Senior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteMARemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Executive Claims Examiner Markel Group IncExecutive Claims ExaminerBoston, MA$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Senior Claim Specialist- GL Mid Market AXA SASenior Claim Specialist- GL Mid MarketMAYou will report to the Claims Manager - Middle Market, Americas Region What you will bring We're looking for someone who has these abilities and skills: Required Skills and Abilities: Broad Property and Casualty claim experience: at least 5 years of experience handling with a focus on litigated and non-litigated general liability claims. By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty.
NewClaims Manager, SDI AXA SAClaims Manager, SDIBoston, MA$139,300–$219,300 / yearClaims Manager - SDI Chicago, IL | Hartford, CT | Exton, PA | New York, NY | Morristown, NJ| Boston, MA | USA As the SDI Claims Manager, you will play a pivotal role in leading a team that handles high-exposure Subcontractor Default Insurance (SDI) claims for some of the largest construction contractors in the industry. By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty.
Claims Consultant W. R. Berkley CorpClaims ConsultantBoston, MA$50–$70 / hourThe company offers a competitive compensation plan which for this role include: o Hourly: $50-$70/hr o This is a temporary role (not permanent) - estimated 3-6 months o Part time 20 - 25 hours a week The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Review, evaluate and, if necessary, respond in a reasonable and timely fashion to demands seeking payment of an insured's total applicable limits of liability, time-limited demands, offers of judgment, demands that Gemini settle a claim within its limits of liability and similar types of demands or offers.
Vertical Account Manager - Claims (Northeast Region) LexisNexis Risk Solutions FL Inc.Vertical Account Manager - Claims (Northeast Region)MAWithin our Insurance vertical, we provide customers with solutions and decision tools that combine public and industry specific content with advanced technology and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our Claims Insurance team works with claims teams within insurance carriers to provide tools and solutions to help better understand the market and manage risk.
Sr Insurance Specialist - Commercial/Blue Cross RIVER VALLEY COUNSELING CENTER INCSr Insurance Specialist - Commercial/Blue CrossHolyoke, MAStrong time management, organization skills and ability to work independently or in a team ï‚· Good plus knowledge of ICS/HCPCS/CPT Coding and medical terminology ï‚· Knowledge of commercial, state and federal healthcare regulations ï‚· Excellent Math Skills and knowledge of general accounting principals ï‚· Ability to logically and accurately organize data ï‚· Excellent problem solving skills ï‚· Strong attention to detail QUALIFICATIONS/JOB REQUISITES: Education: High School Diploma or GED is required, an Associate or Bachelors degree in HealthAdministration or related Study preferred Experience: Eight plus (8+) years in the health insurance, hospital business office or claimsprocessing/management. Required Skills ï‚· Must show honesty, integrity, strong ethics, data entry skills and time management skills ï‚· Insurance follow up experience especially Blue Cross and all Commercial Lines ï‚· Strong understanding of Medetech and finThrive billing programs ï‚· Strong Verbal and written skills for preparing and presenting appeals, negotiating settlementsand presenting reports to Senior Management.
Senior Property Adjuster (Commercial Property Claims) - Boston, MA Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Boston, MAFoxborough, MAPHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
Claim Service Specialist - Springfield, MA - Hybrid ArbellaClaim Service Specialist - Springfield, MA - HybridSpringfield, MassachusettsOur current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $49,010 ($26.00 an hour) - $51,008 ($27.09 an hour) based on a variety of factors including, but not limited to, relevant skills and experience, Please note: The advertised pay range is not a guarantee or promise of a specific wage. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.
Claim Service Specialist - Bridgewater, Quincy, Wakefield, Springfield & Farmington CT - Hybrid ArbellaClaim Service Specialist - Bridgewater, Quincy, Wakefield, Springfield & Farmington CT - HybridQuincy, MassachusettsOur current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $49,010 ($26.00 an hour) - $51,008 ($27.09 an hour) based on a variety of factors including, but not limited to, relevant skills and experience, Please note: The advertised pay range is not a guarantee or promise of a specific wage. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.
Claim Service Specialist -Wakefield, MA - Hybrid ArbellaClaim Service Specialist -Wakefield, MA - HybridMassachusettsOur current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $49,010 ($26.00 an hour) - $51,008 ($27.09 an hour) based on a variety of factors including, but not limited to, relevant skills and experience, Please note: The advertised pay range is not a guarantee or promise of a specific wage. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.
Claim Service Specialist - Bridgewater, MA - Hybrid ArbellaClaim Service Specialist - Bridgewater, MA - HybridBridgewater, MassachusettsOur current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $49,010 ($26.00 an hour) - $51,008 ($27.09 an hour) based on a variety of factors including, but not limited to, relevant skills and experience, Please note: The advertised pay range is not a guarantee or promise of a specific wage. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.
Technical Claims Director- Specialty Hiscox LtdTechnical Claims Director- SpecialtyBoston, MA$180,000–$220,000 / yearThe Role: The Technical Director plays a key role within the Claims organization and is tasked with providing technical expertise in assisting and overseeing Hiscox's larger and more complex claims within the Specialty Claims organization, including Allied Healthcare, A&E, Miscellaneous Professional Liability, Cyber, Crime, and Media and Technology claims, with an emphasis on all aspects of the life of a claim, including reserving and reserving behaviors, implementation and execution of complex claim resolution strategies and partnering with Senior Leadership in Claims, Actuary, Underwriting, Legal and Risk Control. Circa 50% of the portfolio comprises small commercial business sold either online or through intermediaries, and the remaining 50% represents traditionally traded business intermediated through broking partners including Professions, Crisis Management and Specialist lines such as Media & Entertainment.
Claims Assistant - Specialty Claims Hub International LtdClaims Assistant - Specialty ClaimsBoston, MA$19.53–$26.35 / hourTeam player who works well with others, and assists/supports both the claims team and HUB successfully mitigate the overall risk/exposure of HUB clients. The expected salary range for this position is $19.53 an hour - $26.35 an hour and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheBoston, MA$62,500–$115,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.
Claims Administrator Mohawk Global LogisticsClaims AdministratorBoston, MAWho We Are: Mohawk Global is a 350+ person team of logistics and trade specialists dedicated to fulfilling the supply chain needs of our customers with a strong emphasis on customs brokerage, domestic and international transportation, trade compliance, education, and consulting. Additionally, the Claims Administrator supports client retention and risk mitigation by ensuring cargo loss and damage claims are handled professionally, efficiently, and with a strong customer focus.
Insurance Coordinator Specialty1 PartnersInsurance CoordinatorChelmsford, MA$24–$28 / hourE-Verify is used to confirm the employment authorization of all newly hired employees through an electronic database maintained by the Social Security Administration and Department of Homeland Security. Dental Assistants, Sterilization Technicians, Specialists, Office Managers, Patient Care Coordinators and many more all work together to improve the patient care experience and great clinical results.
Medical Billing Specialist PHYSICIAN MANAGEMENT RESOURCES LLCMedical Billing SpecialistNeedham, MAIn this role, you will be responsible for supporting clients in their day-to-billing operations including reviewing, coding, and processing medical claims and well providing a high-level approach to creating workflow processes, analyzing and sharing RCM results. The successful candidate will possess the following: End to end knowledge of the revenue cycle: charge capture, coding, billing, follow up, denials, and payment posting including a strong understanding of payer rules, contracts, and reimbursement methodologies.
Billing & Certified Coding Specialist I (Remote) Lahey Hospital and Medical CenterBilling & Certified Coding Specialist I (Remote)MARemote$25–$34 / hourReviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Stays current on quarterly CCI Edits, bi-monthly Medicare Bulletins, Medicare''s yearly fee schedule, Medicare Website, and specialty newsletters.
Specialist, EDI & Payment Poster East Boston Neighborhood Health Center CorporationSpecialist, EDI & Payment PosterRevere, MassachusettsUnder the direct supervision of the Patient Financial Services Director, the Payment Poster/EDI Specialist is responsible for the accurate and timely processing and posting of all incoming payments and rejections of payment from insurance companies, patients, and third party payers to customer accounts. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly — every role at NeighborHealth is vital.
NewSenior Associate, Forensics - Insurance Risk Management BDO USA PCSenior Associate, Forensics - Insurance Risk ManagementBoston, MA$80,000–$115,000 / yearJob Summary: The Senior Associate - Resilience plays a key role in supporting and delivering advisory services that help clients anticipate, withstand, respond to, and recover from a wide range of operational, strategic, financial, and insurable risks. Familiarity with consulting methodologies, risk and resilience frameworks, and data-driven analysis techniques, including the use of AI and advanced analytics tools to support risk identification, scenario analysis, automation of data review, and development of actionable insights, preferred.
NewSenior Associate, Forensics - Insurance Risk Management BDO International LtdSenior Associate, Forensics - Insurance Risk ManagementBoston, MA$80,000–$115,000 / yearJob Summary: The Senior Associate - Resilience plays a key role in supporting and delivering advisory services that help clients anticipate, withstand, respond to, and recover from a wide range of operational, strategic, financial, and insurable risks. Familiarity with consulting methodologies, risk and resilience frameworks, and data-driven analysis techniques, including the use of AI and advanced analytics tools to support risk identification, scenario analysis, automation of data review, and development of actionable insights, preferred.
Inpatient Medicare Collection Specialist TaraVistaInpatient Medicare Collection SpecialistDevens, MA$24–$28 / hourThis role focuses on Medicare fee-for-service claims, including high-dollar hospital stays, by managing claim edits, resolving denials, and navigating the Medicare Direct Data Entry (DDE/FISS) system to secure accurate and timely payment. The Inpatient Medicare Collections Specialist is responsible for maximizing reimbursement and ensuring timely resolution of Medicare inpatient accounts receivable.
Ambulance Billing & Revenue Cycle Specialist EPOCH HEALTHCARE LLCAmbulance Billing & Revenue Cycle SpecialistNorwood, MAhandle claims submission, payment posting, denials management, and collections for Medicare. • Enter BLS/ALS level-of-service codes, mileage, diagnosis codes (ICD-10), and procedure codes.
Billing Specialist Veterans Inc.Billing SpecialistShrewsbury, MAIn this critical role, you will secure the funding that makes life-saving care possible by navigating complex payer systems, resolving claim denials, and ensuring compliance. You will also collaborate closely with admissions, clinical staff, utilization review, and our external billing contractor to ensure every service is properly documented, authorized, and cleared for seamless reimbursement.
Patient Financial Services Senior Specialist - Hospital Billing Lahey Hospital and Medical CenterPatient Financial Services Senior Specialist - Hospital BillingMA$23–$30.95 / hourHandles payer 277 rejections on accounts with the highest level of complexity and resubmits claims through Epic Billing system or other means of submission (i.e., email, fax, payer portal, certified mail) and provides trends to management for payer outreach and/or internal billing system updates to ensure timely filing and reimbursement. Skills, Knowledge & Abilities: Demonstrates excellent attention to detail and prioritization of accounts · Demonstrates strong working knowledge of Epic Hospital Billing Follow Up and Denial workflows, considered as Subject Matter Expert (SME) to team and other colleagues.
Hospital Billing Specialist (Accounts Receivable) Lowell General HospitalHospital Billing Specialist (Accounts Receivable)Lowell, MA$21.53–$26.91 / hourIn addition, this role focuses on performing the following Billing related duties: Bills patients for administered care, handles incoming payments, calculates patient intake costs, and tracks accounts receivable to ensure accuracy. Regular interaction with other departments of the provider organization using electronic system tools to resolve accounts, including Patient Access, Revenue Integrity, Coding, Medical Records, Utilization Review, Hospital Departments, Physician's Offices, and other administrative teams.