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Provider Service Representative II (Remote)
Commonwealth Care Alliance
-
Boston, MA
The Provider Services Department provides a single point of contact for questions, problem solving, and access to care, for providers on behalf of members of the Senior Care Options (SCO) and One Care Programs. The Provider Services Representative II (PSR) position is responsible for providing accurate, prompt, and courteous service in response to written, electronic and
Email Job
Posted Today
Provider Service Representative II (Remote)
Commonwealth Care Alliance
-
Boston, MA
Interface with CCA's provider departments including credentialing, PDM, Provider Relations and Contracting Answer critical incoming phone calls from providers and respond to inquiries, concerns and questions about coverage, benefits, eligibility and authorization status Navigate through multiple, complex systems and screens while maintaining caller engagement Thoroughly d
Email Job
Posted Today
Remote - Healthcare Privacy Specialist
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Privacy Analyst will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Manager, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be responsible for develo
Email Job
Posted Today
Regulatory Compliance Analyst
WEX, Inc.
-
Portland, ME / San Francisco, CA / Washington, DC / 3 more...
About the Team WEX is seeking a Regulatory Compliance Analyst to join their growing global Risk and Compliance organization, supporting the overall compliance and risk management program for WEX Health.The successful candidate will act as a resource to assist in the building, support, and maintenance of a consistent and scalable regulatory framework for WEX Health, with a
Email Job
Posted 1 day ago
Credentialing Representative
Neighborhood Health Plan of Rhode Island
-
Smithfield, RI
Job Location Smithfield, RI Smithfield, RI Position Type Full Time Education Level Associates Degree   Travel Percentage Frequent Job Shift Daytime Job Category Some Experience Description This position is responsible for processing provider application for network entry and reappointment, including primary source verification of providers credentials according to Pla
Email Job
Posted 1 day ago
Regulatory Compliance Analyst
WEX, Inc.
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Portland, ME / San Francisco, CA / Washington, DC / 3 more...
WEX Inc. (NYSE WEX) is a leading provider of business to business physical, digital, and virtual card payment solutions. WEX's fleet, corporate, and health payment solutions provide its customers comprising small businesses, large fleets, and corporations with unparalleled security and control across a wide spectrum of business sectors. We are executing against a multi pr
Email Job
Posted 2 days ago
Preauthorization Specialist
Newton-Wellesley Hospital
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Newton, MA
Under the direction of the Financial Coordinator Supervisor, ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient's date of service. Collaborates with insurance companies and physician offices when necessary to verify eligibility and authori
Email Job
Posted 2 days ago
Medicaid Eligibility Specialist
Blue Cross and Blue Shield of Rhode Island
-
Providence, RI
Medicaid Eligibility Specialist Blue Cross & Blue Shield of Rhode Island, 500 Exchange Street, Providence, Rhode Island, United States of America Req #1949 Monday, May 13, 2024 Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process. Schedule Hybrid Compensation $22.50 $27.00/hr Jump into the new world of health
Email Job
Posted 2 days ago
Sr Medicare Enrollment Analyst
Blue Cross and Blue Shield of Rhode Island
-
Providence, RI
Sr Medicare Enrollment Analyst Blue Cross & Blue Shield of Rhode Island, 500 Exchange Street, Providence, Rhode Island, United States of America Req #1948 Monday, May 13, 2024 Please email if you are a candidate seeking a reasonable accommodation for the application and/or interview process. Schedule Hybrid Compensation $80,100 $120,200 Jump into the new world of health i
Email Job
Posted 2 days ago
Provider Enrollment Specialist
Optum
-
Boston, MA
Process provider applications and revalidation applications through verifications, credentialing, and site visits Accurately input enrollment data into database system Conduct quality assurance functions to reduce errors and improve processes and performance Demonstrate great depth of knowledge / skills in own function and act as a technical resource to others Educate and
Email Job
Posted 3 days ago
Senior Financial Insurance Authorization Specialist - Infusion Team
Boston Children's Hospital
-
Boston, MA
At Boston Children's Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices
Email Job
Posted 4 days ago
Provider Enrollment Specialist (Remote)
Commonwealth Care Alliance
-
Boston, MA
Why This Role is Important to Us The Provider Enrollment Specialist facilitates the paperwork and timely follow through of all required CCA and CCC employed clinician licenses, registrations, hospital affiliations and insurance enrollments including, but not limited to, state license, DEA & MCSR renewals, NPI registration, CAQH applications, Medicare & MassHealth enrollme
Email Job
Posted 6 days ago
Foundation Program Manager
Bright Horizons Children's Centers
-
Newton, MA
From the very start, Bright Horizons' founders believed that doing well was firmly intertwined with doing good. That mission was formalized in 1999 when the company created the Bright Horizons Foundation for Children. Since then, the organization has provided the framework and the support for employees, clients, vendors, families, and friends to leverage our early learnin
Email Job
Posted 6 days ago
Authorization Coordinator- Prior Authorization/referral experience needed - Hybr
Fallon Health
-
Worcester, MA
The FH authorization process is an essential function to FH's compliance with CMS regulations, NCQA standards, other applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior authorization process as outlined in the Plan Member Handbook/Evidence of Coverage, departmental policies and procedures, and r
Email Job
Posted 6 days ago
Outpatient Financial Counselor
Boston Medical Center
-
Boston, MA
Under the general direction of PFC Manager, the Outpatient Financial Counselor (OPFC) has a dual role to help vulnerable BMC patients to access healthcare coverage and to preserve and protect BMC revenue by securing payors to reduce uncompensated care. The OPFC serves as an advocate and navigator, assisting low income, uninsured and underinsured patients apply for financi
Email Job
Posted 8 days ago
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