Medical Claims Jobs in Springfield (MA)
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Search Results - Medical Claims Jobs in Springfield (MA)
HumanaSpringfield (MA)
Overview
As a Medical Coding Auditor at Humana, you will review medical claims against records to ensure accurate CPT/HCPCS/ICD-10-CM coding. You will interpret coding guidelines and contribute to cost reduction while supporting APC outpatient...
UnitedHealth GroupSpringfield (MA)
years of Python, SQL or R experience; experience with Snowflake or Databricks
• 2+ years of CMS Payment Model Implementations
• 2+ years of working with medical claims and enrollment data in large data warehouses (e.g., Integrated Data Repository...
SCAN Health PlanSpringfield (MA)
experience (or 4+ years in Healthcare/Managed Care)
• Experience with HEDIS and medical claims data preferred
• Advanced MS Office proficiency; strong MS SQL querying skills
• Snowflake experience preferred; SQL Server Reporting Services and Integration...
TEKsystemsSpringfield (MA)
and appeal filings
• Knowledge of specialty pharmacy operations
• Must have pharmacy call center experience (A-level) or healthcare call center/medical claims experience (A- to A+ range)
• communication skills
• collaboration and teamwork
• attention...
SedgwickSpringfield (MA)
Overview
In this role you perform clinical evaluations on disability claims, guiding medical review and ensuring documentation supports claim decisions. You act as a clinical resource to claims examiners and collaborate with providers to validate...
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