37 Results for

Claims Processor Jobs in Cambridge, MA

Jobs

New!

Quincy, MA5 days ago

$100,000–$140,000 Per Year
Full-time

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers.

Norwood, MA8 days ago

$94,000–$152,000

Depending on the experience level, the incumbent is assigned Property Damage and Business Interruption losses, of varying degrees of size and complexity generally in excess of $500,000 and often in excess of $1,000,000 within the Operations geographical area of coverage, or as otherwise directed by the Operations Claims Manager. In addition, the incumbent retains, manages, and controls internal and external consultants, as needed such as Cause & Origin investigators, Building and Machinery Appraisers, Forensic Accountants to aid in the measurement of the losses.

New!

Manchester, NH6 days ago

$77,120–$147,390 Per Year

Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures.

New!

North Andover, MA4 days ago

$60,000–$70,000

Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.

New!

North Andover, MA4 days ago

$60,000–$70,000

New!

Boston, MA3 days ago

$63,590–$121,530 Per Year

Auto Appraiser, you will within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Responsible for reviewing additional damages received from repair facilities to either complete a supplement or triage to field provider method of inspection.

Chelsea, MA8 days ago

$1,895.49–$2,787.72 Per Week

Office machines as normally associated with a professional office environment, including the use of telephones, personal computers, word processing and other software, email, videoconference applications, copiers, scanners and fax machines. While performing duties of this job, the employee is regularly required to use hands to finger, handle, feel or operate objects, including office equipment, or controls and reach with hands and arms.

BJ's Club Support Center Marlborough, MA30+ days ago

The scope includes: ensuring injured team members receive the best possible care, provides oversight of third party claims administrator (TPA) to achieve optimal financial results; partnering with clubs/DC’s and internal partners to ensure that the workers’ compensation benefits are administered according to State regulations; provide training on workers’ compensation benefits; liaising with all external stakeholders including insurance carriers and outside counsel; accurately setting and monitoring the claim reserves; and proactively monitoring claim best practices and new risk management initiatives to reduce claim severity and costs. This includes ensuring TPA best practices are executed; responding to TPA requests for team member information; providing wage information, consults with outside counsel, processes claim billing and funding requests.

Marlborough, Massachusetts12 days ago

$50,000–$60,000 Per Year

Respond promptly and professionally to incoming requests regarding: EOR requests, claim status requests/updates and general claim questions from Account Management, Sales, Brokers, Policyholders and Third-Party Administrators. The key to Berkley’s success is our nimble approach to risk – our ability to quickly understand, think through, and devise a plan that addresses each client’s challenges, coupled with the strong backing of a Fortune 500 company.

Boston, Massachusetts8 days ago

The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Gallagher's Claims and Risk Consulting team includes more than 100 safety and risk control professionals across the country with in-depth knowledge of current and emerging regulations, safety and health management, and operational exposures.

Quincy, Massachusetts30+ days ago

Remote

The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. As a key member of our experienced Claims Adjuster team, you will: Investigate, evaluate, and resolve complex indemnity/lost time workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.

Boston, MA30+ days ago

Remote

$223,800–$313,100 Per Year

The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Medical Director’s work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management.

Manchester, NH30+ days ago

The Director is a key member of the leadership team, partnering closely with leadership, corporate finance, operational leaders, and external stakeholders to support informed decision-making and financial sustainability. This role provides strategic and operational financial leadership, ensuring the accuracy, integrity, and compliance of financial reporting while supporting organizational goals through budgeting, forecasting, cost management, and financial analysis.

Charlestown, MA30+ days ago

Remote

This role requires strong experience with Epic, healthcare registration workflows, and claims processing, along with the ability to multitask efficiently while delivering accurate and timely service. Key Responsibilities:Perform remote patient registration for behavioral health services. About the Client: A leading healthcare organization providing comprehensive clinical and behavioral health services, with a strong focus on patient access, quality care, and operational excellence.

New!

North Andover, Massachusetts6 days ago

$65,000–$75,000

Data analysis & reporting: Analyze data sets to pinpoint root causes of disputes—such as shipping delays, routing non-compliance, or operational gaps—and generate periodic reports on chargeback metrics, recovery rates, trends, and financial impact for management. We offer iconic brands such as NeeDoh®, LAVA® Lamp, Big Wheel®, Schylling hand puppets, Sea-Monkeys® and a variety of other toys that satisfy curiosity, encourage discovery, and help people find their best mellow and chill.

Billerica, MA30+ days ago

This role focuses on high-volume clerical and administrative tasks that help ensure accurate and timely processing of medical billing and patient account information. Candidates should be comfortable working with both digital systems and manual processes, including frequent handwritten notes.

Randolph, MA13 days ago

$60,000–$70,000 Per Year

Our capabilities span fleet maintenance and repair, school and commercial bus sales and service, truck and trailer equipment—including towing, refrigerated transport, yard trucks, and specialty vehicle builds—as well as a full Parts & Tools operation supporting daily maintenance needs. With twelve locations, OEM partnerships, factory-trained technicians, and extensive parts inventories, we provide complete lifecycle support for the vehicles and equipment that keep businesses and municipalities moving.

Needham, MA30+ days ago

You will work closely with the Director of Finance and Clinical Director throughout the year to help manage and develop budgets, track financial status, and perform reconciliations. Manage all accounting/bookkeeping functions, including bill payments, invoicing, accounts receivable, claims reconciliation, general ledger maintenance, and management reporting.

Boston, MA15 days ago

Collaborates with management and peers to ensure all required information is obtained for resolution of charge edits, claim edits, denials, and appeals in a timely manner, while adhering to government/payer regulation and department policy/procedures. With limited supervision, responsible for the timely and accurate submission of all charges and claims as assigned and required to bring issue/problem identification and investigation through to an accepted/successful resolution.

Boston, MA30+ days ago

With its strong 55+ year heritage and deep industry expertise, Capgemini is trusted by its clients to address the entire breadth of their business needs, from strategy and design to operations, fueled by the fast evolving and innovative world of cloud, data, AI, connectivity, software, digital engineering and platforms. The ideal candidate will have 10+ years of P&C insurance product management or consulting experience, strong expertise in personal lines pricing, underwriting, and compliance, and familiarity with technology platforms like Guidewire, Duck Creek, and Majesco.

New!

Brockton, MA2 days ago

Our mission: Through the talents of an experienced and diverse workforce, OCES supports the independence and dignity of older adults and individuals with disabilities by providing essential information and services that promote healthy, safe living which positively impacts our community. As a leader in our mission- driven non-profit, you will manage a team of claims analysts, resolve complex disputes, and optimize workflows to improve financial performance and reduce denials.

New!

Framingham, Massachusetts5 days ago

$90,000–$110,000 Per Year

As a Reimbursement Manager within our Revenue Cycle department, you will play a pivotal role in leading our Accounts Receivable team towards achieving our Revenue Cycle Key Performance Indicators for denial management, cash collections, bad debt, and DSO objectives. Review and improve processes to increase staff and system efficiency to ensure achievement of Revenue Cycle Key Performance Indicators (Minimize upfront claim rejections and denials, bad debt write-offs, reduce DSO and increase daily cash collections).

Boston, MA30+ days ago

Remote

$65,000–$88,600 Per Year

Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Boston, MA12 days ago

The Specialist works both independently and collaboratively with the billing team to manage daily workflows, resolve complex claims, and support overall revenue cycle operations. This role ensures that billing issues are fully investigated and resolved, while maintaining a high level of accuracy and productivity.

Boston, MA30+ days ago

Communicate effectively with physicians and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. This role involves a high volume of daily contacts with members, physicians, and pharmacies to address medication-related issues, promote adherence, and ensure appropriate medication utilization.

Boston, MA30+ days ago

Remote

$78,400–$107,800 Per Year

The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

Westborough, Massachusetts11 days ago

4-6 years of related experience in the healthcare industry, business, with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience. Overview: Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs.

Boston, MA30+ days ago

$165,000–$180,000 Per Year

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Burlington, MA30+ days ago

Provides exceptional customer service to internal and external customers; resolves any patient requests in a timely and accurate manner; escalates complaints accordingly; maintains frequent phone contact with patient, provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate. Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving.

Boston, MA30+ days ago

Cerebral, Inc. is a management services organization that provides health information technology, information management system, and non-clinical administrative support services for various medical practices, including Cerebral Medical Group, PA and its affiliated practices (CMG), who are solely responsible for providing and overseeing all clinical matters. By combining Resilience Lab's Methodology & clinically-led training Institute with Cerebral's extensive reach, clinical network, and care capabilities, we are creating a national model for high-quality, integrated, and accessible behavioral health care.

Boston, MA30+ days ago

Remote

Full-time

Applied experience with GenAI and Intelligent Document Processing to automate document-heavy workflows, with hands-on exposure to prompt design, model iteration, and the ability to explain AI outcomes to both technical and business audiences. You serve as a trusted technical and business advisor, guiding prospects through complex, document-heavy workflows and helping them see a clear path from manual operations to scalable, AI-driven execution.

Charlestown, MA30+ days ago

Handles payer 277 rejections on accounts with the highest level of complexity and resubmits claims through Epic Billing system or other means of submission (i.e., email, fax, payer portal, certified mail) and provides trends to management for payer outreach and/or internal billing system updates to ensure timely filing and reimbursement. Skills, Knowledge & Abilities: · Demonstrates excellent attention to detail and prioritization of accounts · Demonstrates strong working knowledge of Epic Hospital Billing Follow Up and Denial workflows, considered as Subject Matter Expert (SME) to team and other colleagues.

Charlestown, MA30+ days ago

Remote

Under oversight of the Department Manager & Supervisor, the Patient Financial Services Specialist – Hospital Billing will be responsible for efficient & timely billing and collections of hospital outstanding balances on inpatient and outpatient accounts receivable of higher complexity within assigned work queues for a large multi-facility healthcare system with future expansion anticipated to maximize reimbursement to the health system. Handles payer 277 rejections on accounts with higher level of complexity and resubmits claims through Epic Billing system or other means of submission (i.e., email, fax, payer portal, certified mail) and provides trends to management for payer outreach and/or internal billing system updates to ensure timely filing and reimbursement.

Nashua, NH30+ days ago

$153,192–$183,185 Per Year

The role involves reviewing the claim, performing focused assessments of claimed injuries, reviewing medical records, and potentially rendering a medical opinion based on the record review and completed Compensation & Pension (C&P) exam. Conduct Comprehensive Medical Disability Examinations: Perform thorough and focused medical evaluations of Veterans, including reviewing their medical history, conducting physical examinations, and assessing the impact of disabilities on their daily life and functional abilities.

Nashua, NH30+ days ago

$153,192–$183,185 Per Year

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Claims Processor Jobs in Cambridge, MA

Jobs

Claims Examiner MedMalDiedre Moire Corp.

Claims AdjusterFM

SIU Investigator - Multi-Line (Desk)USAA

Personal Lines Account ManagerVaco LLC

Personal Lines Client Success ManagerVaco LLC

Sr. Auto Appraiser - FieldUSAA

Claims Management Specialist (Construction)Massachusetts Water Resources Authority

Sr. Workers Comp Claims SpecialistBJs Wholesale Club

Claims Correspondence AnalystBerkley

Claims AdvocateGallagher

Senior Workers Compensation Claims Adjuster - CT, NH, VT, RI, MAGallagher

Medical Director - Claims ManagementHumana

Director of FinanceAmeriHealth Caritas

Patient Access RepresentativeGTT

Retail Compliance & Chargeback AnalystSchylling

Clerical AssistantConnexion Systems + Engineering

Body Shop EstimatorDeVivo Companies

Medical Office Manager - Billing & CredentialingCrawford Thomas Recruiting

Senior Associate, Physician Billing (hybrid)Boston Children's Hospital

Senior P&C Insurance Product Management SpecialistCapgemini

Health Insurance Billing ManagerOld Colony Elder Services

Reimbursement ManagerHealthDrive

Encounter Data Management ProfessionalHumana

Physician Billing SpecialistBoston Children's Hospital

Pharmacy Coordinator SeniorHighmark Health

Manager, Fraud and WasteHumana

FWA Program Auditor IUniversity of Massachusetts Medical School

Managing Director, , Actuarial ServicesEvolent

In-Clinic Medication Access SpecialistBeth Israel Lahey Health

Join Our Provider Network (Licensed Therapists)Cerebral

Solutions ConsultantIndico Data

Patient Financial Services Senior Specialist - Hospital BillingBeth Israel Lahey Health

Patient Financial Services Specialist (Hospital Billing) RemoteBeth Israel Lahey Health

Examiner Nurse PractitionerLoyal Source

Examiner Physician AssistantLoyal Source

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