778 Results for

Medical Review Specialist Jobs in Boston, MA

Jobs

New!

Boston, MAToday

$197,901–$279,389

Position Responsibilities: • Perform medical examinations, evaluations, assessments, diagnoses and treatment to long term chronic care patients post-acute care inpatients, and/or outpatients. Works closely with other members of the clinical care team including specialty consultants, nurse practitioners, therapists, nursing staff and other care providers.

New!

Dedham, MAToday

$197,901–$279,389

Perform medical examinations, evaluations, assessments, diagnoses and treatment to long term chronic care patients post-acute care inpatients, and/or outpatients. Works closely with other members of the clinical care team including specialty consultants, nurse practitioners, therapists, nursing staff and other care providers.

Billerica, MA30+ days ago

$72,000–$75,000

Kforce' client, a global leading manufacturer in the Billerica, MA area is seeking an Accounts Receivable Specialist to join their growing team that values work life balance, and opportunities for professional growth. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs.

New!

Boston, MAToday

$124,800–$155,933.24

This pharmacist is a member of the Department of Pharmacy with a primary focus of providing comprehensive pharmacy services to patients admitted to Tufts Medical Center with Advanced Heart Failure, including patients before, during, and following heart transplantation and left ventricular assist device (LVAD) implantation. This pharmacist will work with other clinical pharmacists, including working in tandem with an additional inpatient Advanced Heart Failure pharmacist, and with the broader multidisciplinary teams to ensure optimal patient care.

Boston, MA7 days ago

$25–$35

Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.

Waltham, MA7 days ago

$25–$30

Boston, MA7 days ago

$35–$40

Woburn, MA7 days ago

$24–$25

North Andover, MA7 days ago

$47,840–$49,920

Boston, MA7 days ago

$25–$35

Canton, MA10 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, MA3 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.

Boston, MA13 days ago

This role focuses on building strong provider partnerships, driving the adoption of evidence-based tools, and integrating services into multidisciplinary care pathways to maximize clinical impact. This role provides a unique opportunity to make a meaningful impact in oncology, delivering clarity and hope to patients and healthcare providers through innovative precision oncology solutions.

Waltham13 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 .

Boston, Massachusetts15 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, MA16 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.

New!

Wakefield, MA3 days ago

$85,665–$140,736 Per Year

Independent Credit Risk Review, Credit Risk Rating Validation, Transaction Level Credit Analysis, Portfolio & Concentration Risk, CECL / ACL Support & Data Validation, Regulatory Exam Readiness, Issue Identification, Escalation & Follow Up. The job's mission is to provide the Bank with an independent mechanism to assist in early detection of loan problems, ensure accurate loan ratings, monitor compliance with policies, procedures and regulations, and assess portfolio administration of Relationship Managers and Portfolio Managers.

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.

Boston, MA12 days ago

Acquires and maintains proficient knowledge of assigned products and therapies, such as device design and function, product labeling, indications, mechanism of action, care pathways, and overall safety profile (i.e. hazards and harms). They will complete accurate, timely, and consistent medical assessments of adverse events and potential adverse events in order to provide medical expertise, objective oversight and ensure safety vigilance throughout the total product lifecycle.

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.

Needham, MA27 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.

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, Massachusetts13 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.

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.

New!

Woburn, MA6 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

Somerville, MA18 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.

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, Massachusetts11 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.

Attleboro, Massachusetts16 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). .

Plymouth, Massachusetts11 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.

Nashua, NH25 days ago

About the Job: 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, MA25 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, MA9 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.

New!

Boston, MA4 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.

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.

Cambridge, MA23 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, MA19 days ago

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, MA24 days ago

$24–$28 Per Hour

Boston, MA30+ days ago

$18–$24 Per Hour
Full-time

Pay Rate: $18 to $24/hr Summary: Work Mode: 100% Virtual Responsibilities: Triaging incoming appeals and grievances, categorizing them appropriately, and assigning them to the team. Utilizing systems like Pharmacy Benefit Management, Facets, Outlook, Teams, Zoom, and Avaya for processing work.

Charlestown, MA9 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.

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.

New!

Woburn, MA3 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.

Newton, MA26 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.

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.

Cambridge, MA19 days ago

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.

Stand out to leading employers.

Upload your resume and let employers find you for new Medical Review Specialist job openings. Plus, receive relevant job matches delivered straight to your inbox.

Create A Free Account

Medical Review Specialist Jobs in Boston, MA

Geriatric Specialist (N) Hebrew SeniorLife

Geriatric Specialist- RSU Hebrew SeniorLife

Accounts Receivable Specialist Kforce Inc.

Clinical Pharmacy Specialist, Advanced Heart Failure and Heart Transplant, Sign-On Bonus Eligible Tufts Medical Center

Billing Specialist Vaco LLC

Accounts Payable Specialist Vaco LLC

Payroll Specialist Vaco LLC

Accounting Specialist Vaco LLC

Collections Specialist Vaco LLC

Senior Billing Specialist Vaco LLC

Risk Management and Policy Specialist ECLARO

TECH SVCS - IT Lab Computing Support Specialist ECLARO

Clinical Oncology Specialist Sante Consulting LLC

Loan Documentation Specialist Company Confidential

Operations Support Specialist Beacon Hill Staffing Group

Clinical Review Specialist Brigham and Women's Hospital

Credit Risk Review Specialist I Eastern Bankshares Inc

Clinical Review Medical Director - Neurology - Remote UnitedHealth Group Inc

Senior Medical Safety Specialist Gateway Recruiting

Medical Assistant/Patient Service Specialist Boston Medical Center

Medical Billing Specialist PHYSICIAN MANAGEMENT RESOURCES LLC

Medical Billing Specialist Addison Group

Medical Staff Office Specialist Beth Israel Lahey Health

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)

Medical Staff Specialist Brigham and Women's Hospital

Credentialing Specialist, Medical Staff Office Lahey Hospital and Medical Center

Medical Staff Specialist Mass General Brigham

Medical Support Specialist RN Takeda

Senior Medical Billing Specialist Ophthalmic Consultants of Boston

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

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

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

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

Post Market Surveillance Specialist Katalyst Healthcares & Life Sciences

Seasonal/Temporary Hospital Collections Specialist TaraVista

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

Member Appeals Specialist Axelon Services Corporation

Denial Specialist 1-Professional Billing Lahey Hospital and Medical Center

Clinical Pharmacy Specialist - Cardiology Lahey Hospital and Medical Center

Account Specialist, Leasing Operations GTT, LLC

Staff Right of Way Specialist Pyramid, Inc

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

Post Market Surveillance (PMS) Specialist Karwell Technologies

Clinical Pharmacy Specialist - Ambulatory Cardiology Lahey Hospital and Medical Center

Similar Job Searches