Claims Processing Jobs in Massachusetts
downstream systems and reporting integrations. This resource will also be responsible for creating business and functional requirement definitions for claimsprocessing and administration teams.
ROLE RESPONSIBILITIES
Conduct requirement definitions...
PREFERRED QUALIFICATIONS:
- Certified Nurse Practitioner or PA-C.
- Understanding of healthcare industry, claimsprocessing, E&M coding, DRGs, and internal investigative process development.
- In-depth knowledge of, and the ability to understand and apply...
security and server administration.
Experience in data security protocol using encryption and decryption methodologies.
Medicaid or other healthcare or claimsprocessing experience
Strong communication and organizational skills...
- Minimum of 2 full life cycle implementations of SAP S/4HANA.
- Experience leading end-to-end SAP implementation projects.
- Experience working with Quality Teams, Sales Teams, Warehouse Teams, Logistics...
to resolve issues related to claimsprocessing, customer service, and other topics as needed
Adhering to established Commonwealth policy and procedures with respect to project management methodology quality assurance and other related standards
A successful...
- Ensure compliance with warranty regulations and company policies, mitigating risks associated with warranty claims...
Performing annual customer protection reviews and making recommendations for coverage enhancements.
Helping with claimprocessing and resolution.
Builds rapport with each customer. Listens to customers' requests and inquiries.
Works to retain...
- Experience in data security protocol using encryption and decryption methodologies.
- Medicaid or other healthcare or claimsprocessing experience
- Strong communication...
consulting skills with a customer service focus to design and deliver quality products/services that meet or exceed client expectations. The successful candidate will have an extensive medical claims billing and processing background as well as proven...
- Experience in data security protocols using encryption and decryption methodologies.
- Medicaid or other healthcare or claimsprocessing experience.
- Skills:
- Strong...
- Experience with medical claims, medical collections, and handling medical denials
- Familiarity with medical records management and medical terminology
- Understanding of Medicare and Medicaid insurance claimsprocessing
- Proficiency...
for performing claimprocessing and payment functions on non-complex claims for one or more lines of business in multiple states. Responsible for reviewing electronic claim files for completeness and following procedures for gathering missing information...
claims within a real time system. The Pharmacy Business System Analyst will be involved in all aspects of running a pharmacy claimprocessing system. The work includes, but is not limited to, creating project documents, including business and technical...
Responsibilities:
- Trainee is responsible for performing claimprocessing and payment functions on non-complex claims for one or more lines of business in multiple states. Responsible for reviewing electronic claim files for completeness and following procedures...
in a business operation focused on claimsprocessing and/or call center services
Excellent interpersonal skills; will be required to develop and maintain client relationships including facilitating meetings and ensuring all action items resulting from meetings...