768 Results for

Medical Review Specialist Jobs in Boston, MA

Jobs

New!

Boston, MA1 day ago

In conjunction with the Epilepsy Center, TMC Neurology includes a Neurocritical Care Unit (that supports invasive EEG monitoring and Epilepsy surgeries) and a Neuroscience Intermediate Care Unit (stepdown unit) and Neurology med-surg unit with Neurology trained nurses that support elective EEG admissions. The Department also has divisions including Stroke and Cerebrovascular Diseases which supports a Joint Commission-certified Comprehensive Stroke Center, an active Neuromuscular division with a Neurophysiology lab, Movement Disorders, Neuro-Immunology, Neuro-Oncology, and Cognitive Neurology, which supports a multidisciplinary Memory Care Center.

New!

Wilmington, MA2 days ago

$106,500–$197,500 Per Year

The ideal candidate for this position will be proficient in all aspects of the systems engineering process, will have direct and significant experience designing and testing complex systems, and will be comfortable coordinating teams of technical personnel. With customers’ mission-critical needs always in mind, our employees deliver end-to-end technology solutions connecting the space, air, land, sea and cyber domains in the interest of national security.

New!

Wilmington, MA1 day ago

$92,500–$171,500 Per Year

This role will be responsible for full lifecycle Project Engineering support for a range of software and hardware development, assembly, and integration and test efforts to deliver critical space-based remote sensing systems for our customers. Understands how to develop a schedule using Earned Value on a program with $5M-$20M in value and manage a project using the Earned Value Indicators on a DCMA surveilled program (highest rigor applied).

Canton, MA13 days ago

Upgrade current WISP to latest version of NIST800-53v5:Continue evaluation comparison of current WISP which is at NIST800-53v4 to newer NIST800-53v5. ECLARO's client is a market-leading insurance company, providing property, casualty, and specialty insurance services within the United States.

New!

Devens, MA6 days ago

$43.27–$45.90 Per Hour

Minimum of 2+ years of experience working in regulated industries such as Biotech, Pharmaceutical, and Medical Devices familiarity supporting benchtop instruments and applications within a GxP compliant manufacturing or laboratory setting. Review and approve validation lifecycle documents as part of CSV activities, supporting the risk assessments, specifications, pre- and post-approval of qualification testing.

Waltham16 days ago

$30–$31 Per Hour
Temporary
Contractor

Reviews documents for accuracy, timely delivery, and necessary research requirements to ensure documentation reflects the appropriate transactional information and elimination of controllable rework . Ensures that loan documentation and lien perfection meet bank policies and procedures and that work products are delivered in an accurately and timely manner .

New!

Hudson, MA1 day ago

In this role, you’ll help deliver mission-critical components that support U.S. and allied defense, with your skills, creativity, and impact directly contributing to national and global security. Candidates with the following military job codes or similar may have relevant experience for this position: Army MOS: 92A – Automated Logistical Specialist .

Boston, Massachusetts18 days ago

$30–$30 Per Hour
Full-time
Employee

Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com. Our client, a life sciences services company, is seeking an Operations Support Specialist to provide onsite administrative and operational support within a large, well-established research environment in Boston.

Somerville, MA19 days ago

$63,648–$90,750.40 Per Year

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. 2+ years experience with chart reviews in electronic medical records, clinical data, supporting or leading work around quality and improvements and creating and/or presenting education material required.

Boston, MA30+ days ago

Remote

$248,500–$373,000 Per Year

The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. The Medical Director"s activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.

Brighton, MA30+ days ago

$16.35–$22.84 Per Hour

Under the supervision of the Practice Manager, the Medical Assistant I will function as a member of the clinical team and complete assigned daily clinical operations to ensure smooth day-to-day operations in the physician practice. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness.

Braintree, Massachusetts30+ days ago

$24–$28 Per Hour

Review and process incoming payments received via check, credit card transactions, ACH/EFT transfers, and electronic remittance files (835s). The ideal candidate brings prior experience in healthcare billing environments and understands the importance of accuracy, timeliness, and compliance in financial transactions.

Woburn, Massachusetts16 days ago

Minimum 1–3 years of healthcare administration, medical staff services, credentialing, provider enrollment or related experience; 2 years in a hospital MSO or CVO environment preferred. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

Needham, MA30 days ago

In 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.

Boston, MA30+ days ago

Requires a Bachelor's degree from an accredited university or college in Medical Technology or Clinical Laboratory Science which includes successful completion of a supervised course of clinical internship in an approved hospital laboratory, or a Bachelor's degree in an applied science (Chemistry, Biology, Biochemistry). Analytic abilities to perform highly complex testing as defined under CLIA 88 to interpret findings, perform calculations, calibrate instruments, review highly complex testing performed by other employees as defined by CLIA guidelines and so forth.

MA30+ days ago

Remote

$76,208–$125,756 Per Year

The Claims Specialist directs the management of claims including claims investigation, coverage analysis, monitoring of defense counsel activities, control of legal expenses, reserving, and providing technical expertise throughout the life of the claim file. For that reason, we partner with The Predictive Index (PI) - an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one's work style.

Woburn, MA9 days ago

$19.69–$23.63 Per Hour

Sono Bello is America's top cosmetic surgery specialist, with 185+ board-certified surgeons who have performed over 300,000 laser liposuction and body contouring procedures. A career at Sono Bello means being part of a dynamic and high-energy work environment where every team member can make a difference.

Boston, MA30+ days ago

$19.69–$23.63 Per Hour

Cambridge, MA30+ days ago

Remote

$26.44–$43.27 Per Hour

Employment: Full-time Hours/Week: 40 Shift: Day Category: Credentialing / Medical Staff Services Pay Range: $26.44 - $43.27 FLSA: Non-Exempt Req ID: JR90859 330 Mount Auburn Street, Cambridge, MA, 02140 Get directions Get Directions Mount Auburn Hospital 330 Mount Auburn Street, Cambridge, MA 02140 Start Mode Car Transit Bike Walk Transit Bus Subway Train Tram Rail Default Fewer transfers Less walking Avoid Tolls Highways Ferries G Google Maps Apple Maps Waze Apple Maps doesn't support Bike mode; we'll open Driving. We believe in equal access to quality care, as well as employment and advancement opportunities encompassing the full spectrum or human diversity: race, gender, sexual orientation, religion, ethnicity, national origin and all the other forms of group and individual identity and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Somerville, MA21 days ago

$63,648–$90,750.40 Per Year

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. Responsible for managing the end-to-end credentialing process for physicians and advanced practice providers, ensuring confidentiality, regulatory compliance, and coordination with hospital leadership and committees.

Somerville, Massachusetts14 days ago

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. Responsible for managing the end-to-end credentialing process for physicians and advanced practice providers, ensuring confidentiality, regulatory compliance, and coordination with hospital leadership and committees.

Plymouth, Massachusetts14 days ago

As a senior member of the team, you’ll play a critical role in optimizing revenue cycle performance by: Resolving complex claim edits, rejections, and denials with accuracy and efficiency. In this role, you will be a key contributor to the financial health of the organization, tackling complex billing challenges, supporting team development, and helping ensure a seamless experience for our patients and providers.

Attleboro, Massachusetts19 days ago

The actual hourly wage offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. You will determine donor eligibility; to include, proper management of informed consent, AIDS education and confidential self-exclusion, medical history interview and acceptance requirements, physical examination, blood testing, and reviewing Serological Protein Electrophoresis (SPE). .

Nashua, New Hampshire29 days ago

The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for the appropriate level of care orders and documentation to facilitate insurance coverage, and proactively prevent denials. This specialist ensures level of care charges are applied accurately and meet compliance with CMS and commercial insurance guidelines as well as reviewing appeal options for medical necessity insurance denials.

Charlestown, MA28 days ago

Remote

$25–$34 Per Hour

Reviews 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.

Charlestown, MA12 days ago

$24.15–$32.50 Per Hour

Working in an SBO (Single Billing Office), environment the Denial Specialist 3 will need to know Hospital and Professional Billing to assist customers with questions and accurate registration of insurance and or processing physician billing denials. Provides support for the mentoring and training of new and end existing A/R staff as required following the training program set forth to include but not limited to policy and procedures, EHR system functionality, audits and staff reviews.

Beverly, MA14 days ago

$38.31–$84.70 Per Hour

Works with the Director of Coding and Care Coordination to educate the medical staff regarding the importance of complete and accurate documentation, which fully describes the clinical severity of the patient to validate the DRG. Job Description: Beverly Hospital, A member of Beth Israel Lahey Health, promotes the culture and philosophy which enables employees to give and receive the best of care.

Burlington, MA30+ days ago

$21–$28.26 Per Hour

Under direction from the Manager, Health Information Management, a Lead Health Information Management Audit Specialist collaborates closely with other departments/teams to provide efficient and thorough healthcare claims auditing requirements for Beth Israel Lahey Health (BILH) and its affiliates. Researches cases, transfers documentation to electronic media, updates the intra-departmental database, communicates issues and findings to the Director of Internal Audit/Compliance, Director of Case Management, and Coding Manager as appropriate.

Boston, MA7 days ago

Remote

$43–$56 Per Hour

Responsibilities:Credentialing & Provider EnrollmentManage end-to-end provider credentialing and re-credentialing activities in accordance with NCQA, URAC, CMS, and payer-specific requirements. Verify provider credentials, including licensure, DEA registrations, board certifications, malpractice coverage, education, training, and work history through primary source verification.

Cambridge, MA26 days ago

Serves as a liaison between Medical Affairs, Clinical Affairs, Research & Development, Services, and Complaint Handling to ensure Post Market Surveillance (PMS) and Risk Management (RM) processes are executed end-to-end (E2E). Minimum of 4-5 years' experience in Post Market Surveillance within FDA/EU-MDR regulated Medical Device environments with a focus on post-market surveillance plans/reports and post market risk assessment.

Cambridge, MA22 days ago

Charlestown, MA12 days ago

$22.05–$29.68 Per Hour

Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. The PFS Denial Specialist I role is vital to ensure that hospital denied accounts are thoroughly reviewed for any opportunity to correct, refile and or appeal claims for re-processing and reimbursement.

Devens, MA30+ days ago

$24–$28 Per Hour

The Hospital Collections Specialist is responsible for timely follow-up and collection of behavioral health and chemical dependency claims for Inpatient and Outpatient levels of care to ensure timely receipt of payment including but not limited to third party payer receivables. Hospital Collection Specialist will have the following: Must be knowledgeable on Massachusetts insurances as well as commercially insured in state and out of state insurances, Medicaid, and Managed Care insurance.

Devens, MA27 days ago

$24–$28 Per Hour

Boston, MA30+ days ago

$61.53–$78.04 Per Hour

Employment: Full-time Hours/Week: 40 Shift: Day Category: Pharmacy Pay Range: $61.53 - $78.04 FLSA: Non-Exempt Req ID: JR77243 330 Brookline Ave, Boston, MA, 02215 Get directions Get Directions Beth Israel Deaconess Medical Center 330 Brookline Ave, Boston, MA 02215 Start Mode Car Transit Bike Walk Transit Bus Subway Train Tram Rail Default Fewer transfers Less walking Avoid Tolls Highways Ferries G Google Maps Apple Maps Waze Apple Maps doesn't support Bike mode; we'll open Driving. Beth Israel Deaconess Medical Center is growing our transplant program and seeking a Clinical Pharmacy Specialist position with advanced clinical, management and leadership training and experiences to innovate and advance a clinical pharmacy practice model for abdominal transplant services.

Newton, MA29 days ago

$42–$46 Per Hour
Contractor

Experience reviewing and interpreting property related documents, easement agreements, supporting permitting processes and stakeholder database management, coordinating with project teams, and managing multiple projects simultaneously. Key Requirements and Technology Experience: Must Have Skills: Minimum 3 years of applicable experience in Land and Right of Way related agreements, deeds, easements, leases, permits and licenses.

Cambridge, MA22 days ago

Boston, Massachusetts28 days ago

Knowledge of complex/chronic diseases states and therapies used within specialty pharmacy such as but not limited to: Primary Care, Oncology, Transplant, Infectious Disease (including HIV), Multiple Sclerosis, Rheumatoid Arthritis, Gastroenterology, Hepatology, Dermatology, Cardiology, Pulmonary, Allergy and/or various inflammatory conditions preferred. Under protocol, initiates, adjusts, monitors, and recommends changes in drug therapy based on information obtained through patient interviews, objective monitoring parameters, physical assessments as related to drug monitoring and adverse effect management, review of medication profiles and the patient medical records.

Boston, MA30+ days ago

$127,987–$162,318 Per Year

Boston, MA30+ days ago

$127,987–$162,318 Per Year

Job details Employment: Full-time Hours/Week: 40 Shift: Day Category: Pharmacy Pay Range: $127,987.00 USD - $162,318.00 USD FLSA: Exempt Req ID: JR92809 330 Brookline Ave, Boston, MA, 02215 Get directions Get Directions Beth Israel Deaconess Medical Center 330 Brookline Ave, Boston, MA 02215. Knowledge of complex/chronic diseases states and therapies used within specialty pharmacy such as but not limited to: Primary Care, Oncology, Transplant, Infectious Disease (including HIV), Multiple Sclerosis, Rheumatoid Arthritis, Gastroenterology, Hepatology, Dermatology, Cardiology, Pulmonary, Allergy and/or various inflammatory conditions preferred.

Randolph, MA30+ days ago

$24.04–$33.65 Per Hour

Functions include but are not limited to, reviewing patient profiles for duplication of therapy, processing prescription orders, resolving insurance and/or billing issues, and the preparing and of prescription orders for final review by the pharmacist that are ultimately dispensed to the patient either via mail, courier, or picked -up at originating pharmacy. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness.

New!

Woburn, MA6 days ago

Provide account-specific support to the Real Estate Services team by processing customer deliverables and completing milestones within customer databases while also completing all green sheet and Telecommunication system lease management tool ("LMT") deliverables for the Telecommunication services account that produce services revenue. Day to day you will focus on adhering to department protocols and procedures to ensure consistent and repeatable processes, methodologies and tool sets are utilized to improve the Leasing Operations team's efficiency and data quality.

Boston, Massachusetts28 days ago

Beth Israel Deaconess Medical Center is growing our transplant program and seeking a Clinical Pharmacy Specialist position with advanced clinical, management and leadership training and experiences to innovate and advance a clinical pharmacy practice model for abdominal transplant services. Specialists provide comprehensive clinical and distributive medication management services and will utilize their advanced clinical skills in the provision of evidenced-based, safe, and cost-effective drug therapy to achieve optimal medication therapy outcomes.

Boston, MA30+ days ago

$61.53–$78.04 Per Hour

Regularly participates in department initiatives including but not limited to supporting formulary stewardship, presenting new medication requests at Pharmacy & Therapeutics Committee, creating and maintaining policies and procedures, conducting assessments of workflows, and/or developing departmental tools and resources. Reviews and verifies medication orders with consideration, including but not limited to the following patient specific parameters: diagnosis, weight/body surface area, age, allergies, organ function, laboratory values, medication duplication, drug interactions.

Charlestown, MA, MA15 days ago

The job requires use of our Appeals and Grievances system called Jiva (WellSense UM and CM are also working in this system), Member Appeals Specialist duties include: case management of the appeal starting at assignment of the case from the AG Coordinator, evaluating timeliness of the appeal, eligibility of the member, issuing an acknowledgement letter using a template pre-loaded in the system of record, making edits necessary for the case at hand. We will provide training before assigning a small case load and monitor progress of the trainee, the right candidate will: have member appeals experience (not provider claim appeals experience, though a combo of both member and provider is great!).

Boston, MA9 days ago

Remote

$55,000–$75,000 Per Year

With programs like Future of Medicine, which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers, which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care.

Framingham, MA30+ days ago

The position also contributes to global education and training initiatives to support strategic and compliant use of licensed brands while partnering on new tools, workflows, and process improvements across the organization. This role ensures compliance with licensing terms while managing brand resources, purchase order tracking, reporting activities, and royalty payment processes.

Marlborough, MA27 days ago

Partners with Construction, Store Planning, Store Operations, General Contractors, Transportation and Fixture Vendors to ensure fixture orders are accurately created, shipped and delivered on time and installed properly. The Fixture Specialist Junior is responsible for analyzing historical data and coordinating fixture ordering, delivery, and installation across new store, remodel, and special project locations.

Devens, MA30+ days ago

$77,320–$93,699 Per Year

Based on eligibility*, additional time off for employees may include unlimited paid sick time, up to 2 paid volunteer days per year, summer hours flexibility, leaves of absence for medical, personal, parental, caregiver, bereavement, and military needs and an annual Global Shutdown between Christmas and New Years Day. Each of us is empowered to apply our individual talents and unique perspectives in a supportive culture, promoting global participation in clinical trials, while our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.

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Medical Review Specialist Jobs in Boston, MA

Headache, Headache Specialist - Full-Time - Tufts Medical Center, Boston, MA Tufts Medicine

Sr Specialist, Systems Engineer (Space Systems) - MBSE : Sign-on bonus ($20K max) L3Harris Technologies

Specialist, Project Engineering (Space Systems) : Sign-on bonus ($15K max) L3Harris Technologies

Risk Management and Policy Specialist ECLARO

TECH SVCS - IT Lab Computing Support Specialist ECLARO

Loan Documentation Specialist Company Confidential

CONTRACT SPECIALIST The Entwistle Company

Operations Support Specialist Beacon Hill Staffing Group

Clinical Review Specialist Brigham and Women's Hospital

Clinical Review Medical Director - Neurology - Remote UnitedHealth Group Inc

Medical Assistant/Patient Service Specialist Boston Medical Center

Medical Billing Specialist Addison Group

Medical Staff Office Specialist Beth Israel Lahey Health

Medical Billing Specialist PHYSICIAN MANAGEMENT RESOURCES LLC

Medical Technologist Specialist Hematology (40Hrs Days)($5 000 Sign-on Bonus)(External applicants on Boston Medical Center

Claims Specialist - Medical Professional Liability ProAssurance Corp

Medical Receptionist - Patient Experience Specialist Sono Bello

Medical Receptionist - Patient Experience Specialist Body Contour Centers, LLC (Sono Bella)

Credentialing Specialist, Medical Staff Office Lahey Hospital and Medical Center

Medical Staff Specialist Brigham and Women's Hospital

Medical Staff Specialist Mass General Brigham

Senior Medical Billing Specialist Ophthalmic Consultants of Boston

Medical Support Specialist RN Takeda

RN Utilization Review - Patient & Family Services - Per Diem SolutionHealth

Billing & Certified Coding Specialist I (Remote) Lahey Hospital and Medical Center

PFS Denial Specialist 3 Lahey Hospital and Medical Center

Clinical Documentation Specialist (RN)- Per Diem Lahey Hospital and Medical Center

Lead Health Information Management Audit Specialist (On-Site) Lahey Hospital and Medical Center

Certified Provider Credentialing Specialist (CPCS) - #26-13780 US Tech Solutions, Inc.

Post Market Surveillance (PMS) Specialist Katalyst Healthcares & Life Sciences

Post Market Surveillance Specialist Katalyst Healthcares & Life Sciences

Denial Specialist 1-Professional Billing Lahey Hospital and Medical Center

Seasonal/Temporary Hospital Collections Specialist TaraVista

Hospital Collections Specialist, 40hrs Onsite in Auburn, MA TaraVista

Clinical Pharmacy Specialist - Cardiology Lahey Hospital and Medical Center

Staff Right of Way Specialist Pyramid, Inc

Post Market Surveillance (PMS) Specialist Karwell Technologies

Oncology Clinical Pharmacy Specialist, Ambulatory - Solid Tumor Beth Israel Lahey Health

Oncology Clinical Pharmacy Specialist, Ambulatory - Solid Tumor Lahey Hospital and Medical Center

Clinical Pharmacy Specialist - Ambulatory Cardiology Lahey Hospital and Medical Center

Senior Medication Support & Fulfillment Specialist - Mail Order Pharmacy, Sign-On Bonus! Boston Medical Center

Account Specialist, Leasing Operations GTT, LLC

Clinical Pharmacy Specialist - Cardiology Beth Israel Lahey Health

Clinical Pharmacist Specialist - Inpatient Hematology/Oncology (Multiple Positions) Lahey Hospital and Medical Center

Member Appeals Specialist Saviance Technologies

Financial Operations Specialist Care Access

Licensing & Branding Specialist GTT

Fixture Specialist GTT, LLC

Senior Specialist, Facilities - Contract Management Bristol Myers Squibb

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