Senior Consultant, Supplemental Health Sun Life FinancialSenior Consultant, Supplemental HealthWellesley Hills, MA$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.
Inpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerBoston, MA$79,000–$99,750 / yearWhere 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.
Revenue Integrity Specialist Care New England Health SystemRevenue Integrity SpecialistWarwick, Rhode IslandFull timeAbout Us: Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation’s top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. This role focuses on proactive review and resolution of missing or incorrect charges through daily monitoring of Epic Revenue Guardian reports and charge-related work queues, reconciliation of charges against clinical documentation, and collaboration with operational, clinical, and coding teams to ensure compliance with federal, state, and third-party payor guidelines.
IS Application Analyst - Epic Resolute Hospital Billing South Shore Health Systems IncIS Application Analyst - Epic Resolute Hospital BillingWeymouth, MARemote$59,609.13–$140,410.66 / yearReporting to the Access & Revenue IS Manager, the successful candidate will develop workflows, system configurations, change documentation, and train staff on Epic Epic Resolute Hospital Billing application functionality. South Shore Hospital, Southeastern Massachusetts''s leading provider of emergency, acute, and outpatient care, is seeking an experienced Epic Resolute Hospital Billing Analyst to join our IS team.
Diagnostic Imaging Registrar South Shore HealthDiagnostic Imaging RegistrarWeymouth, MA$18.18–$24.47 / hour3. Greets and receives patients, escorts patients to specific areas, assists patients into wheelchair and pushes wheelchair patients to designated hospital departments. Makes all necessary changes to an exam in the event of a missed or inaccurate entry, makes all necessary changes to the exam information in all computer systems to effect proper flow of correlated.
Diagnostic Imaging Registrar South Shore Health Systems IncDiagnostic Imaging RegistrarWeymouth, MA$18.18–$24.47 / hour3. Greets and receives patients, escorts patients to specific areas, assists patients into wheelchair and pushes wheelchair patients to designated hospital departments. Makes all necessary changes to an exam in the event of a missed or inaccurate entry, makes all necessary changes to the exam information in all computer systems to effect proper flow of correlated.
Patient Financial Services Senior Specialist - Hospital Billing Lahey Hospital and Medical CenterPatient Financial Services Senior Specialist - Hospital BillingMA$23–$30.95 / hourJob Description: Essential Duties & Responsibilities including but not limited to: Assists customers with billing/insurance/charge/referral questions to ensure a high level of customer satisfaction · Works with departments throughout the organization to ensure resolution of customer inquiries. Working in an SBO (Single Billing Office), environment, the Customer Service Specialist will need to have knowledge in Hospital, Professional, and Home Health Billing in order to assist the customer with questions related to their bills and statements received from insurance companies.
Clinical Claim Review RN UnitedHealth Group Inc.Clinical Claim Review RNBoston, MARemote$29–$52 / hourThe Clinical Claim Review RN will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. Preferred Qualifications: Clinical or administrative experience in long term care, for example, nursing facility care delivery/administration and/or community-based LTC service programs like Home Health.
Principal Data Engineer CodaMetrixPrincipal Data EngineerBoston, Massachusetts$175,000–$200,000 / yearThe Data Platform team is responsible for executing the data strategy for the organization, ensuring high-quality external data is ingested into the Lakehouse and realized in powerful insights for internal and external customers, while ensuring ML/AI, BI and customer success teams have the data they need to develop and train their models, build insightful dashboards and design semantic layer. Cross-Functional Enablement & Mentorship - Enable ML, BI, Analytics, DevOps, and customer success and implementation teams with training data pipelines, model-ready datasets, feature store architecture, optimized views, dashboards, Tableau refreshes, infrastructure changes, and tenant onboarding.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistRI$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.
Payment Integrity Program Development Senior Manager - Clinical & Facility Specialist Devoted Health IncPayment Integrity Program Development Senior Manager - Clinical & Facility SpecialistWaltham, MARemote$110,500–$150,000 / yearData Hypothesis Validation: Perform primary data analysis (utilizing modern AI tools for SQL query generation) to test your clinical hypotheses across clinical settings, prove financial viability on real-world datasets, and design parameters that prevent provider abrasion. Cross-Functional Policy Leadership: Pitch your original clinical concepts to directors and executive stakeholders; drive consensus across Clinical Operations, SIU, Claims, and Legal to approve novel policy interpretations and rule architectures.
Forward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_Transformation Deloitte Touche Tohmatsu LtdForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_TransformationBoston, MA$105,400–$207,800 / yearWorking knowledge of the retrieval and knowledge layer behind agentic systems - RAG pipelines, embeddings and vector stores, and increasingly knowledge graphs - including how to ground use cases in large volumes of unstructured healthcare data (e.g., clinical notes, payer policies, contracts) alongside structured sources. Partner with Health Care consulting teams and Converge for Healthcare's account and product teams during the sales cycle - running technical discovery, demonstrations, and use-case fit assessments - such as denial prevention, prior authorization automation, or AR follow-up - that qualify client needs and shape a credible path to production value.
Forward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_Transformation DeloitteForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_TransformationBoston, MA$105,400–$207,800 / yearWorking knowledge of the retrieval and knowledge layer behind agentic systems - RAG pipelines, embeddings and vector stores, and increasingly knowledge graphs - including how to ground use cases in large volumes of unstructured healthcare data (e.g., clinical notes, payer policies, contracts) alongside structured sources. Partner with Health Care consulting teams and Converge for Healthcare's account and product teams during the sales cycle - running technical discovery, demonstrations, and use-case fit assessments - such as denial prevention, prior authorization automation, or AR follow-up - that qualify client needs and shape a credible path to production value.
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.
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).
Director, Denials Prevention & Performance Improvement Lahey Hospital and Medical CenterDirector, Denials Prevention & Performance ImprovementMA$165,000–$180,000 / yearThe Director, Denials Prevention & Performance Improvement leads the enterprise-wide strategy for reducing denials, improving upstream workflows, and driving systemic performance improvement across all Revenue Cycle functions. This role oversees denial analytics, cross-functional remediation efforts, clinical and operational partnerships, and digital enablement strategies to strengthen financial outcomes and reduce revenue leakage.
Outpatient Coder Dana-Farber Cancer Institute IncOutpatient CoderBROOKLINE, MARemote$55,600–$63,500 / yearWe strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, AAPC/AHIMA seminars, and other educational forums.
Field Reimbursement Manager-New England Harrow IncField Reimbursement Manager-New EnglandMAMembers of our Harrow Family often express their pride in being a part of our commitment to (1) innovation, (2) patient access to affordable medicines, and (3) our track record of having never turned down an ophthalmologist doing mission work around the world - providing free medicines in support of mission work aimed at giving or maintaining the gift of sight to those most in need. This individual will provide non-promotional, compliant education on coverage, coding, billing, and claims processes - giving customers the confidence and technical know-how to appropriately access and be reimbursed for Harrow brands.
Medical Billing Specialist Medical Billing Specialists, Inc.Medical Billing SpecialistNorwood, MAFull timeIt is essential to follow the constantly changing policies of various insurance payers in order to proactively anticipate operational and workflow-related changes that the billing operation must adhere to in order to avoid unnecessary denials and loss of provider reimbursement. The company is a reputable third-party medical billing firm providing comprehensive billing and consulting services to clients across a wide range of provider specialties.