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4 results for Insurance Verification Specialist in Boston, MA

Claims Administrator/Specialist

Randolph, MA
onsite
Temporary to Hire
30 - 35 USD / Hourly
We are looking for a detail-oriented Claims Administrator to support a general contractor in the greater Boston area . This is a contract-to-permanent position, where you will play a pivotal role in supporting the Director of Risk Management with managing various insurance claims. You will collaborate with adjusters, attorneys, and other stakeholders to ensure claims are investigated thoroughly, processed efficiently, and resolved in a timely manner. Responsibilities:• Assist in managing and overseeing insurance claims, including general liability, workers' compensation, and auto liability.• Collaborate with adjusters, attorneys, and third-party carriers to investigate claims and determine liability.• Prepare comprehensive loss runs and claims reports to identify trends and areas of focus.• Compile and organize documentation required for Discovery requests and litigation processes.• Handle small nuisance claims that may not fall under existing insurance coverage.• Assess tender opportunities and make recommendations on settlements.• Provide support for claims related to construction, environmental liability, and property risks.• Ensure accurate processing of claims and maintain compliance with industry standards.• Utilize industry knowledge to interpret construction documents and evaluate construction litigation cases.• Work closely with stakeholders to address inquiries and provide updates on claim statuses.
2026-04-21T00:00:00Z

Medical Cash Applications Specialist

Shrewsbury, MA
onsite
Permanent / Full Time
55000 - 63000 USD / Yearly
We are looking for a detail-oriented Medical Cash Applications Specialist to support payment posting and account reconciliation activities in Shrewsbury, Massachusetts. This position plays an important role in maintaining accurate financial records, resolving payment variances, and partnering with billing teams to keep revenue cycle operations running smoothly. The ideal candidate brings healthcare accounts receivable experience, strong analytical skills, and a solid understanding of payer documentation and reimbursement practices. Responsibilities:• Record insurance, patient, and third-party payments, denials, and adjustments in the billing platform with a high level of accuracy.• Compare posted transactions against remittance documents, EOBs, ERAs, and related records to confirm that payment activity is complete and correct.• Review reimbursement differences, trace the source of posting issues, and take action to correct errors or escalate unresolved items when needed.• Enter contractual allowances and approved write-offs according to payer agreements and established reimbursement schedules.• Investigate unidentified receipts, rejected transactions, missing payments, and other cash application exceptions by coordinating with payers, internal teams, and leadership.• Support compliance by following healthcare billing standards, payer rules, and applicable regulatory requirements tied to payment posting activities.• Perform routine audits of cash application work to protect data integrity and ensure account balances reflect accurate financial activity.• Prepare summary reporting on posting accuracy, reconciliation results, and cash activity for management review.• Work closely with billing staff to address claim or account issues that affect payment application and overall accounts receivable performance.• Recommend workflow enhancements that improve efficiency, strengthen accuracy, and support timely completion of daily posting responsibilities. For immediate consideration please reach out ASAP Eric Lebow 508-205-2127
2026-04-20T00:00:00Z

IT Security Specialist

Cambridge, MA
onsite
Permanent / Full Time
90000 - 110000 USD / Yearly
We are looking for a dedicated IT Security Specialist to join our team in Cambridge, Massachusetts. The ideal candidate will play a key role in maintaining the integrity, confidentiality, and security of data across our systems. This position requires a proactive individual with a strong background in cybersecurity and governance practices. Responsibilities: • Implement and monitor security protocols to ensure the protection of sensitive data and systems. • Conduct regular audits and assessments to identify vulnerabilities and ensure compliance with data privacy regulations. • Develop and enforce security policies and procedures to safeguard computer files and databases. • Collaborate with cross-functional teams to address cybersecurity risks and enhance overall security posture. • Analyze security incidents and provide recommendations for mitigation and prevention. • Manage and maintain secure access controls for databases and information systems. • Provide training and awareness programs to educate staff on cybersecurity best practices. • Stay up-to-date with emerging threats and technologies to continuously improve security measures. • Assist in the development and execution of governance strategies related to cybersecurity. • Prepare detailed reports on security performance and compliance findings for management review.
2026-04-09T00:00:00Z

Medical Claims Analyst

North Providence, RI
onsite
Temporary / Contract
17.1 - 19.8 USD / Hourly
Position SummaryWe are seeking a detail-oriented Claims Analyst for a long-term contract on site in Providence, RI. Strong experience in Coordination of Benefits (COB), orthodontic or medical claims processing, and suspended/pended claims resolution. This role requires a thorough understanding of industry guidelines, plan provisions, and claim adjudication processes to ensure accurate and timely claim outcomes. Key ResponsibilitiesCoordination of Benefits (COB) Processing<ul><li>Review and adjudicate claims to determine primary and secondary coverage in accordance with COB rules</li><li>Verify subscriber and dependent eligibility across multiple insurance plans</li><li>Apply industry-standard guidelines to ensure accurate benefit determination</li><li>Calculate correct payment amounts following primary insurer adjudication</li><li>Adjust claims based on Explanations of Benefits (EOBs) received from other carriers</li></ul>Orthodontic Claims Processing<ul><li>Evaluate orthodontic treatment plans for coverage eligibility and plan compliance</li><li>Verify lifetime maximums, age limits, and plan-specific orthodontic provisions</li><li>Process initial banding/bonding claims and ongoing periodic payments</li><li>Calculate prorated payments over the course of treatment</li><li>Monitor continuation of treatment and confirm ongoing patient eligibility</li></ul>Suspended / Pended Claims Handling<ul><li>Analyze suspended or pended claims to identify errors, missing documentation, or review flags</li><li>Determine root causes such as eligibility discrepancies, coding issues, or COB conflicts</li><li>Prioritize suspended claims based on aging, urgency, and service-level agreements (SLAs)</li><li>Escalate complex or high-risk issues to senior analysts or supervisors as appropriate</li><li>Ensure timely and compliant resolution in accordance with turnaround time standards</li></ul>
2026-04-07T00:00:00Z