Hospital Collections Specialist, 40hrs Onsite in Auburn, MA MiraVistaHospital Collections Specialist, 40hrs Onsite in Auburn, MADevens, MA$24–$30 / hourThe 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.
Patient Access Associate Specialist - PRN Ensemble Health PartnersPatient Access Associate Specialist - PRNNashua, New HampshirePatient Access Associate Specialist are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey. This role ensures data integrity, regulatory compliance, and a positive patient experience while directly influencing revenue cycle KPIs such as registration accuracy, point-of-service collections, and first-pass claim rates.
Pharmacy Technician - Customer Care Specialist Onco360Pharmacy Technician - Customer Care SpecialistWaltham, MassachusettsRemoteOnco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturer s. Work with other functional areas to resolve customer problems, and in system databases, and notifying appropriate parties as to what action will be taken to resolve the problem.
Specialist, EDI & Payment Poster East Boston Neighborhood Health Center CorporationSpecialist, EDI & Payment PosterRevere, MassachusettsUnder the direct supervision of the Patient Financial Services Director, the Payment Poster/EDI Specialist is responsible for the accurate and timely processing and posting of all incoming payments and rejections of payment from insurance companies, patients, and third party payers to customer accounts. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly — every role at NeighborHealth is vital.
Medical Coder II/III CodaMetrixMedical Coder II/IIIBoston, MassachusettsThis role requires a proven ability to communicate highly complex coding issues and solutions to a wide range of stakeholders, alongside an unwavering commitment to continuous learning, quality, and innovation in medical coding practices. They will play a pivotal role in improving the quality and efficiency of coding operations by collaborating closely with cross-functional teams, including Machine Learning, Product, and Customer Implementations.
Patient Access Associate Specialist Ensemble Health PartnersPatient Access Associate SpecialistNashua, New HampshirePatient Access staff are responsible for assigning accurate MRNs, completing medical necessity / compliance checks, providing proper patient instructions, collecting insurance information, receiving, and processing physician orders, and utilizing an overlay tool while providing excellent customer service as measured by Press Ganey. Responsible for accurately screening of medical necessity using the Advanced Beneficiary Notice (ABN) software to inform Medicare patients of possible non-payment of test by Medicare and distribution of the ABN as appropriate.
B2B Collections Specialist Ledgent Finance & AccountingB2B Collections SpecialistWaltham, Massachusetts$27–$32 / hourManage complex B2B, A/R activity including credits, debits, rebills, tax exempt adjustments, customer deductions, and correcting misapplied payments. Our renowned engineering client Headquarters in Waltham, MA is seeking a B2B Cash Collections specialist to join their team immediately in a 3 month, full time contract.
Patient Services Coord. III Brigham and Women's HospitalPatient Services Coord. IIIBoston, MA$19.37–$27.71 / hourPerforms a wide range of administrative tasks utilizing well established skills and experience to support a medical office, including surgical scheduling, prior authorizations, medical office coding and billing as well as coordinating patient services such as appointments, testing, and referrals; Performs administrative coordination of a physician's office to include secretarial support, data management and billing/financial support. 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.
Client Service Specialist Paul HastingsClient Service SpecialistBoston, MassachusettsIn this capacity, the Client Service Specialist will: Maintain a consistent physical presence to foster a collaborative and interactive environment, optimizing assignments, cross-training, and peer-level support to ensure seamless operations for the practice; Serve as a facilitator of client communications and coordinator of client meetings; Oversee administrative functions and ensure timely completion of tasks, including finance and billing-related tasks, time and expense entries, opening of new matters, creation and maintenance of client presentations, and other administrative projects as assigned; Draft, format, and proofread legal documents, including pleadings, motions, subpoenas, discovery requests, TOAs/TOCs, and correspondences. Proficiencies: Proficiency in Intapp Time, Chrome River, and iManage; Proficiency in Table of Contents and Table of Authorities; Ability to effectively prioritize and multitask, demonstrating collaboration, delegation, and teamwork; Strong attention to detail; Advanced proficiency of English grammar, spelling, and punctuation; Advanced proficiency in MS Word, document editing, and comparison tools; Advanced proficiency in MS Outlook and web-based conference call/web-sharing applications; Advanced proficiency in MS Excel, including spreadsheet and database applications; Advanced proficiency in MS PowerPoint and presentation tools; Advanced knowledge of timekeeping, expense processing, and billing; Proficiency in document management systems; Ability to thrive in a fast-paced environment, working both independently and within a team; and.
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.
NewASR II - Orthopedic Surgery Boston Medical CenterASR II - Orthopedic SurgeryBoston, MA$22.36–$27.26 / hourThe incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.). POSITION SUMMARY: The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.).
NewASR II - Radiology Boston Medical CenterASR II - RadiologyBoston, MA$22.36–$27.26 / hourThe incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.). POSITION SUMMARY: The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.).
NewASR II Boston Medical CenterASR IIBoston, MA$22.36–$27.26 / hourThe incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.). POSITION SUMMARY: The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.).
NewAmbulatory Service Rep ll Boston Medical CenterAmbulatory Service Rep llBoston, MA$22.36–$27.26 / hourThe incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: front end customer service, patient registration, insurance/coverage verification, appointment scheduling, charge entry, billing and managed care, and a variety of administrative duties in support of department (such as coordination of physician credentialing, handling phones & mail, filling out forms, filing, photocopying, faxing, preparing letters, reports, etc.). POSITION SUMMARY: The incumbent in this role will support the clinical practice by focusing on billing and managed care functions (including charge entries, billing edits, charge reconciliations, responding to billing inquires, corresponding with insurance carriers, investigating billing discrepancies, etc.).
Financial Counselor- Hybrid Boston Children's HospitalFinancial Counselor- HybridBoston, MAThe Financial Counselor plays an essential role in supporting patient families and hospital financial operations by providing timely financial guidance, cost estimates, and assistance navigating insurance coverage and financial assistance programs. This role supports pre-service financial clearance by helping families understand their financial responsibilities, assisting with public health insurance applications, resolving insurance-related questions, and ensuring accurate patient billing information.
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.
NewCollection Representative Brigham and Women's HospitalCollection RepresentativeSomerville, MA$17.71–$25.28 / 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.
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.
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.
Inpatient DRG Reviewer ZelisInpatient DRG ReviewerBoston, MassachusettsWhere the regrouped ‘new DRG’ differs from what was originally claimed by the provider, write a customer facing ‘rationale’ or ‘findings’ statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.