Managed Care Services Representative Brigham and Women's HospitalManaged Care Services RepresentativeSomerville, MA$21–$28.30 / hourThe 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. Managed Care Services Insurance Verification Representative is vital for the team and you will be serving as a liaison between the hospital, insurance companies, and patients to ensure proper coordination and reimbursement for healthcare services.
Managed Care Services Rep Brigham and Women's HospitalManaged Care Services RepSomerville, MA$19.81–$28.30 / hourThe 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. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.
NewCareer Advancement Specialist (B) TriangleCareer Advancement Specialist (B)Malden, MAFull timeTriangle's Expectation of EmployeeAdheres to Triangle policy and procedures Fosters a positive, solution-oriented culture consistent with Triangle's missionPromotes employment, self-advocacy, and independence across programs and participantsActs as a role model within and outside of Triangle Maintains a positive and respectful attitude towards participants, staff, and community partnersCommunicates regularly with supervisor Demonstrates flexible and efficient time management and ability to prioritize workloadConsistently reports to work on time prepared to perform duties of position, with a willingness to flex hours as neededPrimary Responsibilities Equips individuals with disabilities with job readiness skills to secure potential employment or collegiate pathwaysCreates an inviting, exciting, innovative, learning environmentTakes lead in developing and implementing activities and employment/collegiate opportunities focused on personal and professional development Aids in the development & implementation of new and engaging career and social experiences to meet program/participant driven goalsProduces weekly supported employment schedule/monitors utilization of contractsConsistently connects with community employers in order to identify or create employment opportunities/collegiate support for individuals Facilitates and implements after hours social opportunities and community engagement Establishes opportunities for training and job shadowing with local community businessesDeveloping job leads and cultivates employer relationships to enhance community partnershipsMonitors individual job performance, attitude, and behavior for appropriatenessImplements independent living, self-advocacy, and soft skills into daily activities and programmatic offeringsProvides individualized support to participants, when necessary, both during programming and 1:1 job/collegiate pathway coaching Conducts initial/ongoing assessments for personal growthProactively communicates with families over employment/collegiate progress and needsProvides support to participants and assists in developing natural support to ensure integration and increased or maintained independence in the communityTrains and develop independent skills related to employment and collegiate pathways, such as travel training, hygiene, self-advocacy, etc. Provides transportation for groups or individual career seekers to interviews, employment assessments, job searching, and other employment activities in the communityCommunicates in a professional manner with employers/collegiate stakeholders and trouble shoots issues at supported sites with all relevant partiesWorks with Case Management team to ensure individual's ISP/Life Plan goals are being metParticipates in ISP/Life Plan meetings with Department of Developmental Services, participants, and their families or other members of their support team as neededTake directions from Site Manager/Assistant to collect accurate data as needed for ISP/Life Plans, behavior plans, monthly progress notes, etc.
Registered Nurse Crossway HomecareRegistered NurseLynn, Massachusetts$40–$45Communication with the patient’s physician (verbally and/or in writing) to obtain effective treatment modalities and/or rehabilitative therapy modalities to effect the best means to obtain the desired outcome for the specific medical problem that caused the case to open and/or recertify. Job Description: We are seeking compassionate and dedicated Full-Time Home Care Nurses (RN) to provide exceptional, patient-centered care in the North Shore Region of Massachusetts -* Including but not limited to: _*Lynn, Salem, Peabody, Beverly and surrounding areas.*_.
Senior Specialist (Manager), Order Management Systems and Processes Lantheus Holdings IncSenior Specialist (Manager), Order Management Systems and ProcessesBedford, MA$111,000–$185,000 / yearReporting to the Director of Commercial Order Management Systems, this role partners cross-functionally to deliver process improvements, support and implement system enhancements, and maintain operational stability across OTC workflows. Lantheus (NASDAQ: LNTH) is the leading radiopharmaceutical-focused company, delivering life-changing science to enable clinicians to Find, Fight and Follow disease to deliver better patient outcomes.
Third Party Reviewer Brigham and Women's HospitalThird Party ReviewerSomerville, MA$19.81–$28.30 / hourThe 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. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.
Accounts Receivable Lead SarnovaAccounts Receivable LeadBoston, MAThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
Pharmacy Benefits Verification Specialist Onco360Pharmacy Benefits Verification SpecialistWaltham, MassachusettsSkills/Knowledge: Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Pharmacy Benefit Verification Summary The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs.
Senior Revenue Cycle Business Analyst The Employee ConnectSenior Revenue Cycle Business AnalystBoston, MassachusettsRemoteYour primary responsibilities include: Analytics and Reporting: Design, develop, and maintain sophisticated dashboards and reports using Epic Clarity and SQL to track key revenue metrics, identify bottlenecks, and monitor performance across billing, collections, and accounts receivable functions. You will serve as a strategic bridge between clinical operations and financial management, leveraging advanced analytics and technical expertise to drive organizational efficiency and revenue optimization.
Medicaid Provider Support Specialist Harbor CareMedicaid Provider Support SpecialistNashua, NHRemoteThe Medicaid Provider Support Specialist promotes best practices that enhance compliance, improve service delivery, and expand access to high-quality peer recovery support services for Medicaid beneficiaries while supporting Harbor Care's philosophy of care and values of compassion, respect, collaboration, accountability, and transparency. The Medicaid Provider Support Specialist plays a vital role in advancing Harbor Care's mission and vision by strengthening the capacity of Recovery Community Organizations (RCOs) participating in the Peer Recovery Support Services Facilitating Organization grant program.
NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWaltham, MassachusettsSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
NewSenior Plan Coordinator Consultant -Employee Assistance Program CVS Health CorpSenior Plan Coordinator Consultant -Employee Assistance ProgramMA$18.50–$38.82 / hourPartners with key stakeholders, including Sales, Account Management, and other internal business teams, to proactively identify, resolve, and prevent issues while consistently meeting or exceeding customer expectations. This individual will support the implementation and ongoing maintenance of client plans by accurately translating benefit design and pricing information into a custom Aetna EAP system for member and plan sponsor servicing, claim processing, and billing purposes.
Payment Integrity Program Development Manager Devoted Health ServicesPayment Integrity Program Development ManagerMassachusettsRemoteThat’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. (Note: We provide modern AI tools to generate and edit SQL scripts; you do not need to be a software expert, but you must possess the ability to read, interpret, and understand data scripts to validate results and analyze proof-of-concept datasets).
Accounting/Data Entry Specialist Ledgent Finance & AccountingAccounting/Data Entry SpecialistLynn, Massachusetts$20–$25 / hourThis role is ideal for someone looking to gain hands-on experience who enjoys data entry, organization, and learning new systems, and who is comfortable working onsite in a collaborative, small‑team environment. An independent Pre‑K through Grade 8 school in Marblehead is seeking a Part‑Time Accounting & Data Entry Assistant to support the Finance and IT teams during a system conversion and preparation for the new school year.
Payment Integrity Program Development Manager Devoted Health IncPayment Integrity Program Development ManagerWaltham, MARemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. (Note: We provide modern AI tools to generate and edit SQL scripts; you do not need to be a software expert, but you must possess the ability to read, interpret, and understand data scripts to validate results and analyze proof-of-concept datasets).
NewAccounts Receivable Specialist Pharmaron Beijing Co LtdAccounts Receivable SpecialistWaltham, MA$75,000–$80,000 / yearFounded in 2004, Pharmaron has invested in its people and facilities and established a broad spectrum of research, development, and manufacturing service capabilities throughout the entire drug discovery, preclinical, and clinical development process across multiple therapeutic modalities, including small molecules, biologics, and CGT products. We're looking for an Accounts Receivable Specialist to join our growing finance team and play a key role in managing customer accounts, driving collections, and ensuring timely payment of outstanding invoices.
Client Relations Specialist LaBovick Law GroupClient Relations SpecialistQuincy, MassachusettsJoin our growing PIP (Personal Injury Protection) team as a Client Support Specialist , where you’ll play an important role in helping our medical provider clients obtain timely payment from insurance carriers for services rendered under the PIP statute. This position offers a great balance of remote work and travel —you’ll spend approximately 40% of your time visiting client sites , cultivating relationships, and ensuring documentation accuracy.
NewAccounts Receivable Collections Specialist (Remote Near a WRE Branch) Wind River Environmental LLCAccounts Receivable Collections Specialist (Remote Near a WRE Branch)Marlborough, MARemote$21–$24 / hourLocation Requirement: This is a remote role for an individual who reside within 25 miles of one of our branch locations in the following states: Connecticut, Florida, Georgia, Maryland, Massachusetts, New Hampshire, New Jersey, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia. Wind River Environmental services and maintains a broad array of non-hazardous liquid waste systems, including grease traps, septic tanks and related waste systems.
IP Practice Team Specialist Cooley LLPIP Practice Team SpecialistBoston, MA$83,200–$110,240 / hourBilling and finance support: • Proactively keep the pre-bill review process moving to lessen the attorney's workload and take responsibility of timely returning pre-bills to Accounting • Work in partnership with Financial Services and client account specialists to compile reports and analyze data as needed • Serve as the liaison between client and collections on special billing requirements, discrepancies, write-offs and discounts as directed • Request and analyze client billing charts and monitor client matter budgets • Assist with the practice expense approval process • Take initiative to process expense reimbursements • Assist in the international invoice approval process, approve credit memos from international agents. Competencies: • Customer service oriented, as demonstrated by strong attention to detail, organization and ability to prioritize work tasks and manage deadlines based upon internal and external client needs • Ability to work independently and under pressure/tight time constraints • Creative and entrepreneurial approach to problem-solving and process improvement • Flexible and agile, ability to reprioritize with changes in the business • Strong initiative and a get-it-done attitude • Excellent communication and interpersonal skills.
NewCoding Coordinator-Inpatient (Remote) Lahey Hospital and Medical CenterCoding Coordinator-Inpatient (Remote)MARemote$29–$40 / hourDept./Unit-Specific Skills: Coder 1 level ICD-10-CM, ICD-10-PCS Inpatient code assignment skills based on BILH Coding exam. 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.