The Sr. Claims Auditor utilizes CPT and ICD 10 coding to review physician claims and medical records for coding accuracy. Internal auditing functions focus on "desktop reviews" of claims, design and quality control of future audits, and other auditing related functions. Review clinical notes and claims submitted to verify the appropriateness of codes billed based on servi

Participate in negotiations of contract language, terms and conditions, cost/price, deliverables, and schedule requirements Facilitate and provide contractual guidance to internal management including sales and finance Work with internal stakeholders to assure compliance with contractual requirements during contract execution and communicate contractual obligations to acc

YOUR MISSION Budget/forecast, analyze and report on sales, margin and expense performance for ECOM Provide reporting and analysis of ECOM results vs historical and budgeted figures Provide detailed commentary on month end results from a sales and financial expense standpoint Support month end process including reporting, data validation, and calculation of accruals Assist

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable

Technology Specialists in WilmerHale's intellectual property ("IP") practice are involved in a wide variety of types of work supervised by attorneys, including patent prosecution, client counseling, opinions, patent litigation and IP transactional matters. For example, Technology Specialists typically work with inventors; prepare patent applications and replies to communi

Analyze, select and profitably price coverage for commercial risks and determine terms and conditions of coverage on new and renewal business. Apply and conform to underwriting rules and guidelines, rating manuals, insurance laws/ regulations. Utilize a consultative selling approach to generate new business consistent with underwriting strategy and in coordination with se

RAND is seeking highly motivated analyst s and experienced practitioners who would like to apply their system acquisition expertise to Analysis of Alternatives ( AoA ) , Business Case Analysis (BCA) , and other related analyse s to directly impact government acquisition policy . The U.S. federal government spends hundreds of billions of dollars each year to acquire and su

To direct and manage the US Miscellaneous Medical & Life Sciences (US MMLS) team within Healthcare. To deliver and execute the annual business plan, set and direct forecasts. To underwrite a Miscellaneous Medical account within the Healthcare team and provide counsel and advice on Underwriting and market issues. Provide technical expertise in this business area and mainta

The Massachusetts Gaming Commission seeks to hire a Financial Monitoring Analyst. This position is responsible for working alongside various department staff to conduct financial monitoring and analysis of gaming and sports wagering operations on a monthly, quarterly, and annual basis. Analytic work includes, but is not limited to, review, validation, and analysis of fina

The Commercial Credit Underwriter (CCU) position is designed and intended to prepare individuals for the role of Portfolio Manager I or a future Credit Professional role by providing specific on the job training as well as experience working within a Lending Team environment. CCUs report directly to the Commercial Credit Officer. The position is accountable primarily to t

Content Claims Specialist Field Level I Requisition ID 2024 24911 Job Locations US MA Boston Position Type Regular Full Time Category Claims Business Unit CUS_Loss Adjusting US Excellence In Everything We Touch Position Summary The role of Content Claims Specialists is a multi faceted role, which focuses primarily in the following four key areas of edjuster's content clai

Under the direction of the Financial Coordinator Supervisor, ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient's date of service. Collaborates with insurance companies and physician offices when necessary to verify eligibility and authori

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable

Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) Alert Supervisor and Special Investigations Unit to potentially suspect claims Ensure timely denial or payment of benefits in accordance with jurisdictio

We're looking for a Customer Service Representative. Be the important link between Safelite and our customers – where you’ll provide phone based support in a variety of processes such as claims processing or scheduling. This role delivers the critical first impression that sets the stage for an extraordinary experience. Find a Career. Gain a Family. Safeli