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.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)ME$43,888–$102,081 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Revenue Integrity Analyst InterMed, P.A.Revenue Integrity AnalystSouth Portland, MEPart timeGiven InterMed's payer mix and its blend of fee-for-service and value-based reimbursement, this role requires fluency across multiple reimbursement methodologies and the ability to prioritize work based on financial materiality and risk. Perform contract yield analysis: compare expected reimbursement (per commercial and Medicare Advantage fee schedules) to actual payments to identify underpayments and variance patterns.
Senior Consultant, Supplemental Health Sun Life Financial IncSenior 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, MaineThrough 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.
Claim 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.
NewSenior Observation Medical Coder UnitedHealth Group IncSenior Observation Medical CoderPortland, ME$24–$43 / hourWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.
NewAccount Follow-Up Representative I Harris Computer SystemsAccount Follow-Up Representative IMaine, MERemote$18–$26 / hourTimely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient's insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals.
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.
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.
NewClinical Review Nurse I - Medicare Part B Elevance Health IncClinical Review Nurse I - Medicare Part BSouth Portland, ME$67,200–$100,800 / yearIf this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. This position is part of our Wellpoint Federal division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
NewClinical Review Nurse I - Medicare Part B Elevance HealthClinical Review Nurse I - Medicare Part BSouth Portland, ME$67,200–$100,800 / yearIf this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. This position is part of our Wellpoint Federal division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
NewSenior Data Scientist - Clinical Informatics (Analytics Enablement) CVS Health CorpSenior Data Scientist - Clinical Informatics (Analytics Enablement)ME$83,430–$222,480 / yearExperience designing patient-centric data models, feature stores, and dashboards that aggregate longitudinal data across sources, including demographics, encounters, conditions, medications, labs, utilization, cost, and enrichment attributes. A&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses.
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.