Senior Coding Associate - Customer Insights athenahealth IncSenior Coding Associate - Customer InsightsME$77,000–$131,000 / yearWe offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients - powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. What we can do for you: Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces - some offices even welcome dogs.
Inpatient Coding Auditor Huron Consulting GroupInpatient Coding AuditorMaine, MERemote$38.46–$52.40 / hourPHYSICAL DEMANDS: This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments.
Practice Manager - Sanford & Saco, ME ConvenientMDPractice Manager - Sanford & Saco, MESanford, Maine$90,000–$115,000 / yearDual-site management experience: Proven ability to successfully oversee operations across multiple clinic locations, balancing priorities, optimizing workflows, and ensuring consistent team performance and patient experience at each site. As a dual Practice Manager at both our Sanford & Saco, Maine urgent care clinics, you will play a pivotal role in the day-to-day operational efficiency of the clinics while contributing to their long-term strategic goals.
Medical Billing Specialist-Accounts Receivable New England Cancer SpecialistsMedical Billing Specialist-Accounts ReceivableWestbrook, MERemote$46,800–$59,500 / yearYou are responsible for the full accounts receivable life cycle, including analyzing and researching unpaid claims, assisting in the resolution of denials, partial payments, and over-payments as well as communicating with payers, patients and other team members. Identify and resolve denials and improper payments by accessing payer web applications, completing forms and telephoning account representative per New England Cancer Specialists policies.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)ME$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Revenue Integrity Specialist ConvenientMDRevenue Integrity SpecialistPortsmouth, New HampshireThe Revenue Integrity Specialist works collaboratively with clinical, coding, billing, operational, and revenue cycle teams to identify, investigate, and resolve issues impacting charge capture, claim accuracy, reimbursement, operational efficiency, and clean claim submission while supporting revenue integrity and operational improvement initiatives. This role supports operational revenue cycle workflows through charge review, billing issue resolution, claim validation, operational monitoring, and workflow support activities designed to ensure accurate claim submission, billing integrity, and reimbursement performance across front-end, mid-cycle, and back-end revenue cycle processes.
Senior Consultant, Supplemental Health Sun Life FinancialSenior Consultant, Supplemental HealthPortland, ME$71,100–$106,700 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Senior Consultant, Supplemental Health Sun LifeSenior Consultant, Supplemental HealthPortland, Maine$71,100–$106,700 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Medical Office Specialist Job Vision Source LPMedical Office Specialist JobRochester, NHThis role is ideal for a seasoned medical or optical front office professional who is confident in their skills, takes ownership of their work, and can help guide day-to-day front desk workflows. Rochester Eye Care Associates is seeking an experienced Medical Office Specialist to serve as a lead presence within our front desk operations.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistME$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
Clinical Documentation Improvement Nurse Coder (Certified) Martin's Point Health Care LLCClinical Documentation Improvement Nurse Coder (Certified)Portland, METhe Clinical Documentation Improvement (CDI) Nurse Coder supports accurate and complete clinical documentation that reflects the severity of illness, quality of care, and services provided to patients. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day.
Senior Product Manager (PM/RCM) - Full Time - Remote Experity IncSenior Product Manager (PM/RCM) - Full Time - RemoteMERemote$107,750–$151,400 / yearResponsibilities: Own day-to-day execution of the Revenue Cycle Management product roadmap, ensuring on-time delivery of capabilities across charge capture, coding, claim creation and submission, payer processing, payment posting, denial management, accounts receivable, patient balances, reporting, and related billing workflows. Deep knowledge of healthcare revenue cycle management, including charge capture, coding, claim submission, clearinghouses, payer adjudication, remittance processing, denial management, accounts receivable, and payment posting.
Medical Director MPO CVS Health CorpMedical Director MPOME$174,070–$374,920 / yearIn this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. Additional responsibilities may include: Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services.
Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubME$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Business Development Executive (MedInsight) Milliman IncBusiness Development Executive (MedInsight)Portland, MERemote$120,635–$199,065 / yearMedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. Primary Responsibilities: Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
Hospital Inpatient Coder - Revenue Integrity - Full Time SolutionHealthHospital Inpatient Coder - Revenue Integrity - Full TimeNHThe Hospital Inpatient Coder collaborates with providers and coding leadership to resolve coding discrepancies, contribute to quality improvement efforts, and uphold organizational goals related to revenue cycle performance and compliance. About the Job: The Hospital Inpatient Coder is responsible for accurately assigning ICD-10 and DRG codes to hospital inpatient services in accordance with current coding guidelines, payer requirements, and regulatory requirements.
Medical Director - ENT CVS Health CorpMedical Director - ENTME$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOME$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
Clinical Assurance Spec/RN Northern Light HealthClinical Assurance Spec/RNSouth Portland, ME$32.65–$50.11 / hourResponsibilities: Analyzes clinical documentation (including OASIS documentation) and diagnoses for accuracy while maximizing appropriate reimbursement for the organization Utilizes critical thinking and organizing skills to ensure the timely processing of all SOC/ROC, re-certification, and resumptions of care and discharge assessments Reviews OASIS for completeness and accuracy on admissions, re-certifications, resumptions of care and discharges and communicates needed changes to appropriate staff Collaborates with others to review CMS additional documentation requests, monitor for trends and reports to clinical leaders Problem solves and troubleshoots documentation for coding discrepancies, logical inconsistencies, errors, and completeness Performs chart audits, assesses for trends, and communicates findings to clinical leaders Makes corrections in electronic medical record as needed Other Duties as assigned Other Information: Current license to practice as a Registered Nurse, Physical Therapist, Occupational Therapist or Speech Therapist in the State of Maine BLS for Healthcare Providers certification is required to be obtained prior to independent visits. Credentials Required Registered Nurse Required Driver''''s License Education Required Bachelor''''s DegreeIn lieu of education, two years of experience is required per year of required education, exclusive of the minimum experience identified above Working Conditions Potential exposure to abusive and/or aggressive people.
Physical Therapist - Outpatient CJ Physical Therapy & PilatesPhysical Therapist - OutpatientPortsmouth, NH$85,000–$115,000 / yearBut if the idea of joining a growing company early, helping shape what comes next, and having opportunities that don't even exist yet sounds exciting - keep reading. If you're tired of being told how many patients to see, fighting insurance for what your patients actually need, and watching your skills plateau because your clinic doesn't actually invest in you - keep reading.