- UpvoteDownvoteShare Job
- Suggest Revision
Establish and continuously review reserves and input claim information in the Mobile Claims System (MCS). Assign claims to appropriate CMS or other Selective claim units when outside scope of Service Center handling.
$62,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
This position and is responsible for designing quality and control assurance reviews of claims, Hierarchical Condition Categories (HCC) and clinical coding, call monitoring, system technology upgrades, and other critical compliance/financial/operational controls and processes across the CCA enterprise, including all health plan and care delivery activities.
Full-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Assists in implementing and maintaining, and identifying enhancements for a comprehensive document management system for all CSB claims and monitors related claim milestones and deadlines.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
FRM will collaborate with case manager and case coordinator on average of 4 x month and ad hoc as needed for escalations, these interactions are tracked in FRM CRM and hub system. As an FRM, your duties will include but is not limited to Prior Authorization assistance, Claims Assistance, and Appeals and educating the office on the Payer landscape.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Prior state government/public sector experience with health and human services programs (such as Medicaid, Medicaid Management Information System (MMIS), claims processing, eligibility, HHS analytics, Eligibility and Enrollment systems (i.e., NC FAST), etc.
RemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of Masshealth/Medicaid system. Submits claims to health insurers, follows up with health insurers about submitted claims, and performs appeals for non-clinical denials, etc.
Part-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Proven in depth understanding of QNXT integrated healthcare system, including finance, enrollment, claims, provider network, and system configuration modules. NET, and Visual Studio and to analyze, troubleshoot, and code specific to an integrated healthcare system and its interface to QNXT.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The system allows them to register their businesses, file claims for underground tank incidents (e.g., a leakage, etc.) The system allows administrators to manage the COC, Claims and other associated processes.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
An ideal candidate will have hands on experience testing on the Duck Creek platform and have a strong background in commercial P&C insurance underwriting or claims IT experience. Prior experience with the Duck Creek Platform or equivalent P&C system is an advantage.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Learn and access the electronic MassHealth system to research information necessary to respond to questions related to MassHealth eligibility, third party insurance, prior approval, and claims.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
- Suggest Revision
In this role, the selected candidate will be an integral and collaborative member of the DCF Health and Medical Services Team (HMST), as well as partnering with the Substance Abuse, Domestic Violence, Mental Health and Disability, Plan of Safe Care, LGBTQIA, Education Specialist and Mental Health specialists within the region, to support the social work teams.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Identify children who are appropriate for the Special Kids/Special Care program, complete the referral form and submit the referral to MassHealth. DCF works toward establishing the safety, permanency and well-being of the Commonwealth's children by stabilizing and preserving families; providing quality temporary alternative care when necessary, safely reunifying families; and when necessary and appropriate, creating new families through kinship, guardianship or adoption.
$158,514.72 a yearFull-timeExpandApply NowActive JobUpdated 13 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Experience or knowledge of ONYX, FACETS and/or similar provider data and/or claims processing system. Provides system analysis support as needed to ensure operational compliance with Plan provider and database rules.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
This includes the alignment of revenue cycle functions such as patient access, billing, coding, claims, and collections with system-wide policies, procedures, and best practices. Revenue Cycle Technology: Oversee the integration and optimization of multiple revenue cycle technology platforms, such as electronic health records (EHR), billing systems, and claims management tools.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Billing Specialist (6 month Temporary) will be responsible for reviewing billing recommendations generated from a proprietary system and ensuring that claims are submitted accurately and compliantly.
$34.33 an hourTemporaryExpandApply NowActive JobUpdated 6 days ago
system claims jobs in Wakefield, MA
FEATURED BLOG POSTS
7 Importances of Organizational Culture and How to Build It
The world of work has drastically changed in the past few years. Where a good salary and a nice office might have been enough to attract talent in the past, employees today expect flexibility, growth opportunities, and a healthy work environment. In fact, 77% of applicants say they’d consider a company’s culture before applying for a job.
Collaborative Recruiting: The Key to a Better Talent Acquisition Strategy
Talent acquisition is a multi-stage process where candidates undergo various application steps before getting hired. The unfortunate reality is that it is a labor-intense system, with the hiring manager and recruiter often handling all of the work on their own. Ask any one of them, and you will hear about the overabundance of applications and the demanding task of filtering through them to find the best candidates. The quality of talent suffers under the weight of all that work on one person's hands. It's not easy, but as many companies are starting to realize, there is a better way. The future of talent acquisition lies in collaborative recruiting!
4 Talent Acquisition Trends Going Into 2023
For better or worse, a side effect of the COVID-19 pandemic was a marked shift in talent acquisition practices worldwide. With the struggle to retain talent that began in 2020, companies have had to rethink recruitment strategies. The result has been new talent acquisition trends that are well on their way to becoming commonplace. These are the practices that are going to become even more widespread going into 2023.
Why is Professionalism Important & How to Be Professional
You might have heard the word professionalism thrown around in the workplace, but do you know what it means? And do you know how to maintain professionalism no matter the circumstances?
Why Cover Letters Are Important & How To Write One | Job\Searcher
Most people completely waste their cover letter real estate. Your cover letter is another opportunity to speak directly about how your background and capabilities align with the opportunity you seek. It also allows you to introduce your personality a bit more than a resume does. So, why are cover letters important? Because you can stand out, big time, with a custom cover letter directed to the right person.
Hiring Again After Mass Layoffs
It's never an easy decision to let members of your staff go, but depending on the state of your business, mass layoffs may have been the only way to survive. Now that you're months into the future, you may find yourself itching to start hiring again after previous layoffs.
Why Are Internships Important & How Can You Get One?
Internships are for college students or people who have just completed their degree. If you are a student or recent grad, you may be wondering how to land an internship. If you've never had one, you may even wonder if you need one. After all, didn’t you work in that call center while also doing exams? Or perhaps you’ve bartended your first year in college?