UM Specialist — Denials & Coordination Expert
Point32Health
Point32Health is seeking a UM Specialist in Massachusetts to support non-clinical reviews within the Utilization Management department. Under the Precertification Team Manager, you will coordinate coverage determinations for designated products and prepare medical necessity denial letters, ensuring timely and accurate processing. The role emphasizes training, audits, and collaboration with provider networks and internal teams. #J-18808-Ljbffr Point32Health
- Aspire Health and Community Services is seeking a detail-oriented Medicaid Biller & Follow-Up Specialist to manage the full revenue cycle, including claim submission and denial resolution, ensuring accurate billing and timely reimbursement. Ideal candidates will have 2+...Suggested
$24.7 - $37.05 per hour
...the Precertification Team Manager, the UM Specialist is responsible for the daily management... .... The UM Specialist is responsible for coordination of coverage determinations for special... ...products or accounts, all medical necessity denial letters and monitoring of daily...SuggestedWork experience placementWork at officeWork from home$24.7 - $37.05 per hour
...Utilization Management Specialist Point32Health is a leading not-... ...Precertification Team Manager, the UM Specialist is responsible for... ...is responsible for coordination of coverage determinations for... ...accounts, all medical necessity denial letters and monitoring of daily...SuggestedWork experience placementWork at officeWork from home- ...capabilities globally. WHERE YOU’LL FIT WITHIN THE TEAM As a Senior Specialist, Customer Success, ETF, you’ll play a key role in delivering... ...to stakeholders, helping identify the best talent solutions, coordinating sourcing and onboarding activities, and ensuring a seamless...SuggestedFull timeFor contractorsFreelanceWork at officeLocal area2 days per week
$105k - $140k
Bond Building Construction Inc. is seeking a Virtual Design & Construction Specialist in Norwood, MA. The role involves leading the VDC process, managing BIM tools, and collaborating with project teams. Successful candidates will have a Bachelor's degree or equivalent...Suggested- ...A property management company in Boston seeks a Recertification Specialist to manage the recertification process. Key responsibilities include verifying resident information and ensuring compliance with housing programs. Candidates should have at least 3 years of property...
- ...Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure...
$22.25 - $35.6 per hour
Boston Health Care for the Homeless Program is hiring a full-time Billing Coordinator to ensure accurate processing of patient claims. The role will involve submitting claims to governmental and third-party payers, verifying benefits, and resolving billing issues. The ideal...Hourly payFull time- A public school district in Massachusetts is seeking a BTU Specialist to provide support to students with disabilities and those placed at risk. The role entails collaboration with principals and other educational staff to deliver tailored educational support. Candidates...
- Bay Cove Cape Cod in Boston is looking for a Revenue Cycle Posting Specialist who will ensure accurate payment processing and reconciliation in accordance with established standards. The ideal candidate should have substantial experience in payment posting and bank reconciliation...
- Elliot Health System is seeking a Hospital Accounts Receivable Specialist responsible for timely billing and claims resolution. This role involves preparing and submitting claims, resolving outstanding account balances, and collaborating with internal departments for accurate...
$32.69 - $33.65 per hour
Bay Cove Human Services in Boston is seeking a Revenue Cycle Posting Specialist to help manage electronic claims submissions and ensure compliance with payment standards. The role requires strong understanding of accounting principles and experience in payment posting...Hourly pay$125k
A global healthcare innovator seeks an Advanced Surgical Consultant to support cardiac care in Boston, Massachusetts. This field-based position involves training and supporting healthcare professionals on the use of Impella devices. Candidates should have a strong background...- A major healthcare facility in Boston is seeking an experienced MRI Technologist. The role involves safely performing MRI studies, preparing patients, and ensuring adherence to safety protocols during procedures. Qualified candidates must hold a Certificate/Diploma in Medical...
- AccuFile, Inc is seeking a Records Specialist in Boston, MA. The role involves creating and maintaining a records management system, maintaining firm archives, and providing file retrieval services. Candidates should have 1-3 years of records experience, strong proficiency...Work at office
- Finishes Specialist / Cabinet Finishing Expert Position We are seeking a Finishing Specialist to apply high-quality finishes to custom kitchen cabinetry. The role involves selecting and applying finishes that meet aesthetic and durability standards, collaborating with design...
- A global freight forwarding company based in Boston is seeking an experienced Customs Entry Writer. The ideal candidate will manage the clearing of goods through U.S. Customs, ensuring compliance with federal regulations and maintaining customer communication. Responsibilities...
- ...operations based inBoston, MassachusettsandSan Francisco, California. Position Summary Reporting to the Head of PV Ops, the Senior Specialist, Drug Safety will support individual case safety report (ICSR) processing and ensure a high level of quality of safety cases. The...Remote work
- A leading healthcare institution in Boston is seeking a registered cardiac sonographer to perform comprehensive echocardiograms and utilize various techniques for accurate diagnostic results. The ideal candidate should have at least an associate degree with RDCS or CCI ...
$24.15 - $32.5 per hour
Beth Israel Lahey Health is looking for a Denial Specialist 3 in Boston, MA. This full-time position focuses on resolving complex and high-dollar claims denials while working closely with supervisors and managers. Candidates should have 3 years of experience and an associate...Hourly payFull time$22.05 - $29.68 per hour
Beth Israel Lahey Health is seeking a PFS Denial Specialist I in Boston, Massachusetts. This role is essential for reviewing denied accounts and ensuring thorough handling for potential corrections and reimbursements. Candidates should possess excellent analytical skills...Hourly pay$22.05 - $29.68 per hour
...Description When you join the growing BILH team, you’re not just taking a job, you’re making a difference in people’s lives. The PFS Denial Specialist I role is vital to ensure that hospital denied accounts are thoroughly reviewed for any opportunity to correct, refile and or...Hourly payWork at officeImmediate startShift work$24.15 - $32.5 per hour
Beth Israel Lahey Health is seeking a Denial Specialist 3 in Boston, Massachusetts. This role focuses on resolving high-dollar and denied claims, ensuring accurate submissions and compliance with billing guidelines. The ideal candidate will have at least three years of...Hourly payShift work$24.15 - $32.5 per hour
...time • DayWhen you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.The Denial Specialist 3 role specializes in high-dollar claims, aged claims, and denied claims for complex specialties. This role identifies and works...Hourly payFull timeWork at officeShift work$45k - $65k
Medium is seeking a Group Reservations Specialist to support group-related reservation needs. This fully remote position involves coordinating multiple participants, communicating with clients, and maintaining accurate records. Ideal candidates are detail-oriented and have...Remote job$19.81 - $28.3 per hour
...professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As... ...require Patient Care? No Essential Functions Oversees, coordinates and administers the financial/business records, systems and processes...Hourly payRemote workShift work- ...to oversee case management for SSH&EC patients at Weymouth, MA. You will review medical records, determine medical necessity, and coordinate discharge planning and post-acute care with physicians, nurses, and payers. Responsibilities include utilization review using...Part timeNight shiftWeekend workAfternoon shift
- ...Accounts Receivable Specialist New England Life Care (NELC) is one of the fastest growing home infusion therapy services companies... ...better Demonstrate independence and competence to work basic denials Demonstrate independence and competence in payer requirements...Temporary workWork at officeLocal areaRemote workWork from homeMonday to Friday
- A local staffing agency in Boston is seeking a Background Check Specialist/Project Coordinator for a 12-month contract role. In this position, you will coordinate and monitor the processing of background checks, provide administrative support, and respond to inquiries...Contract workLocal area
- Background Check Specialist/Project Coordinator Contract Title: Background Check Specialist/Project Coordinator Duration: 12 Months The Background Check Specialist is responsible for: Coordinating and monitoring the processing of Background Record Checks by performing...Full timeContract workPart timeWork at office
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