3 results for Medical Coding Manager in Providence, RI

Medical Claims Analyst

North Providence, RI
onsite
Temporary
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

Medical Reimbursement Specialist

Weymouth, MA
onsite
Temporary
23.75 - 27.5 USD / Hourly
We are looking for a skilled Medical Reimbursement Specialist to join our team on a long-term contract basis in South Weymouth, Massachusetts. In this role, you will play a vital part in supporting hospital financial operations by analyzing reimbursement processes, maintaining accurate records, and ensuring compliance with regulatory standards. This position requires a strong background in hospital billing, revenue analysis, and financial reporting. Responsibilities: • Analyze monthly revenue performance against budget and investigate variances related to reimbursement, volume, and charges. • Prepare and post journal entries for contractual allowances in Accounts Receivable, ensuring accurate reconciliations. • Collaborate with finance and departmental teams to develop and support the annual hospital budget. • Assist in the creation of presentations for hospital leadership, providing insights into financial performance. • Direct the preparation and filing of third-party cost reports and regulatory documentation. • Support annual audits by preparing necessary financial data and ensuring compliance with audit standards. • Extract and analyze data from systems such as Experian and Strata to assist in budgeting, forecasting, and productivity modeling. • Identify opportunities to streamline processes and implement improvements to enhance operational efficiency. • Maintain detailed records and reserves for contractual allowances to ensure financial accuracy.
2026-04-01T00:00:00Z

Medical Receptionist

Brockton, MA
onsite
Temporary
18.05 - 20.9 USD / Hourly
We are looking for a dedicated Medical Receptionist to join our healthcare team in Brockton, Massachusetts. In this long-term contract position, you will play a crucial role in ensuring smooth daily operations and delivering exceptional service to patients. This opportunity is fully onsite, offering consistent weekday hours. Responsibilities: • Manage patient scheduling by coordinating appointments and maintaining an organized calendar. • Professionally answer and direct incoming calls to provide prompt assistance. • Handle patient check-in and check-out processes with efficiency and attention to detail. • Accurately input patient demographics and other essential information into eClinicalWorks software. • Deliver excellent customer service to ensure a welcoming environment for patients. • Collaborate with medical staff to support administrative tasks and improve workflow.
2026-04-09T00:00:00Z