Clinical Appeals Nurse Reviewer | Coding & Denials Expert
Blue Cross Blue Shield of Massachusetts
Blue Cross and Blue Shield of Massachusetts Inc. seeks a Clinical Appeals Nurse Reviewer to facilitate and respond to provider appeals for denied services. The candidate will work collaboratively with various teams, applying clinical, coding, and business knowledge to resolve claims appeals. The ideal applicant must be a Registered Nurse with current Massachusetts licensure and hold recognized coding credentials, alongside significant acute care experience. A variety of benefits, including paid time off and medical insurance, are provided. #J-18808-Ljbffr
- ...Blue Cross Blue Shield of Massachusetts is looking for a Clinical Appeals Nurse Reviewer to transform healthcare by facilitating and coordinating... ...collaborating with various teams while utilizing your extensive coding knowledge and clinical judgement. You’ll ensure accurate...SuggestedFull time
$41.72 - $50.99 per hour
...Blue Cross and Blue Shield of Massachusetts, Inc. is hiring a Clinical Appeals Nurse Reviewer in Hingham. This role involves responding to provider appeals for denied services, utilizing clinical judgement, coding knowledge, and collaboration with various departments. Key...SuggestedHourly payFull time- Community Care Cooperative (C3) is searching for a Senior Outpatient Coder in Boston. This role involves conducting coding audits, assigning diagnosis and procedure codes, and ensuring compliance with guidelines. Applicants must have 10+ years of experience in outpatient...Suggested
- South Shore Health System in Weymouth, MA is hiring a Professional Coder I to ensure accurate coding for outpatient and inpatient procedures. You will analyze medical documentation, assign diagnostic codes, and work collaboratively with healthcare providers to clarify...Suggested
$41.72 - $50.99 per hour
...your true colors to blue. The Role The Clinical Appeals Nurse Reviewer facilitates, coordinates, and... ...clinical, regulatory, business, and coding knowledge. Collaborates with the Physician... ...will serve as a liaison and business expert for claims appeals. This role works collaboratively...SuggestedShift workNight shift$41.72 - $50.99 per hour
...your true colors to blue. The Role The Clinical Appeals Nurse Reviewer facilitates, coordinates, and... ...clinical, regulatory, business, and coding knowledge. Collaborates with the Physician... ...will serve as a liaison and business expert for claims appeals. This role works collaboratively...Hourly payFull timeNight shift$41.72 - $50.99 per hour
Role The Clinical Appeals Nurse Reviewer facilitates, coordinates, and responds to provider appeals for denied services utilizing extensive clinical, regulatory, business, and coding knowledge. This role works collaboratively with Provider Service, Claims, Network Management...Hourly payFull timeNight shift- ...training pipelines, plus top AI researchers who specialize in coding, reasoning, STEM, multilinguality, multimodality, and agents; and... ...Assurance & Collaboration: Actively participate in two-tier reviews, meticulously evaluating both accuracy of problems and...Contract workFor contractorsFreelanceRemote work
- ...A healthcare provider is seeking a Hospital Inpatient Coder to accurately assign ICD-10 and DRG codes for inpatient services. Responsibilities include interpreting medical documents and ensuring compliance with coding standards. Candidates should have a high school diploma...Remote workMonday to FridayShift work
- ...A healthcare provider in New Hampshire is looking for a Hospital Inpatient Coder to ensure accurate coding of hospital inpatient services. The ideal candidate will have at least 2 years of coding experience and relevant certifications. Responsibilities include assigning...Full timeRemote work
$18 - $34 per hour
...leader is seeking a Medical Coder to work remotely in Quincy, Massachusetts. The role involves accurately assigning ICD-10 diagnosis codes, performing billing tasks, and ensuring compliance within the Ambulatory Surgical Center setting. Ideal candidates will have a high...Hourly payRemote work$18 - $34 per hour
Shields Health in Quincy, Massachusetts, is seeking a Medical Coder to ensure accurate coding of surgical services. This role involves assigning ICD-10 codes, reviewing surgical procedure codes, and supporting the revenue cycle in a fast-paced environment. Qualifications...Hourly pay$96.8k - $251.6k
...modern data platforms to solve problems like clinical decision support, revenue optimization,... ...Experience with blending hands-on coding with smart adoption of AI-driven solutions... ...dental, and vision insurance, including expert medical opinion Short term disability...Temporary workFlexible hours- A premiere animal healthcare provider in South Weymouth, MA, is looking for an Experienced Radiology Technician to enhance their Diagnostic Imaging Team. This role emphasizes expertise in sedation and anesthesia and involves collaboration with specialists across multiple...Flexible hours
$33.64 - $49.98 per hour
Boston Medical Center (BMC) is seeking a Certified Surgical Tech in Brockton, Massachusetts. The role involves acting as the primary scrub person during surgical procedures, ensuring the highest standard of sterile techniques, and assisting the surgical team as required...- Tufts Medicine is looking for an entry-level Surgical Technologist II to support complex surgical procedures in Boston. This role involves assisting surgeons and maintaining a sterile environment for patient safety. The ideal candidate will possess a high school diploma...
- ...South Shore Health in Weymouth, Massachusetts, is seeking a dedicated Registered Nurse to manage individualized, outcome-oriented nursing care. The ideal candidate will coordinate the delivery of care in line with hospital policies and promote patient family-centered care...
- ...South Shore Health System is seeking an Oncology Registered Nurse in South Weymouth, Massachusetts. The nurse will focus on patient assessment, education, and coordination of care for oncology patients, administering therapies such as chemotherapy, and providing compassionate...
- ...South Shore Health System in Weymouth, Massachusetts is seeking a Registered Nurse to manage individualized, outcome-oriented nursing care. This role entails administering medication, documenting patient care tasks, and ensuring compliance with safety protocols. The ideal...
- ...Yale New Haven Health is seeking a Registered Nurse in Hingham, Massachusetts. The RN will assess and supervise patient care according to unit policies and procedures while ensuring a high level of service. Responsibilities include developing care plans and supervising...
$112k - $162.5k
...Boston Medical Center is seeking a licensed and credentialed Nurse Practitioner (NP) to provide quality medical care, including diagnosis... ...nursing license. The role includes responsibilities such as clinical practice supervision, patient care management, and maintaining...$126.84k - $173.87k
Mass General Brigham is seeking a Nurse Practitioner to join their team providing patient care during night shifts. This role involves assessing and admitting patients, serving as the first contact for existing patients, and ensuring high-quality documentation. A Master...Night shift$50k - $60k
The Talbots LLC, located in Hingham, MA, is seeking a Pricing & Promotions Analyst responsible for managing promotions, pricing, and markdown processes for the Outlet channel. The role requires strong analytical skills, proficiency in Microsoft Excel, and the ability to...$102.56k - $125.64k
...suited for an Epic revenue cycle expert with knowledge of Epic... ...end billing, registration and clinical workflows within FQHCs or complex... ...integrity metrics, such as denials and charge accuracy Provide detailed... ...standards, Epic workflows, coding accuracy, and payer...Work at office- Brigham & Women's Faulkner Hospital is seeking an OR Assistant to support the surgical team in providing quality patient care. This role involves preparing operating rooms, assisting in patient transport, and maintaining cleanliness in the surgical area. Ideal candidates...Daily paidShift work
- South Shore Health in Weymouth, Massachusetts, seeks a Registered Nurse to manage individualized, outcome-oriented nursing care. The RN will ensure patient safety, facilitate medication administration, and uphold compliance with healthcare standards. The ideal candidate...
- South Shore Health is hiring a Registered Nurse in Weymouth, MA, to manage individualized nursing care effectively. The role involves administering medications, maintaining safety standards, and ensuring proper documentation of patient care. The ideal candidate will have...
- ...South Shore Health System in South Weymouth seeks a Certified Registered Nurse Anesthetist (CRNA) to provide anesthesia care and monitor patients during various medical procedures. The role requires administering anesthetic agents, ensuring patient safety, and conducting...
$34 - $40 per hour
Clean Harbors in Weymouth, MA is seeking an experienced HM183 Tank Inspector to join their safety-conscious team. The role involves conducting visual, internal, pressure, and leak tests on various hazardous material tanks. The ideal candidate will have over 3 years of experience...Hourly pay- ...Harbor Health is seeking Per Diem Nurse Practitioners to join our Primary Care and Specialty... ...-based medicine. Provides timely and expert care to patients with acute illness. Manages... ...Record (EMR) appropriately using proper coding and documents care accordingly;...Hourly payDaily paidWeekend workDay shiftAfternoon shift
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