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System Admin Professional Services

Whitinsville,MA

1296 System Admin Professional Services jobs in Whitinsville,MA

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Information Systems Technician

U.S. Navy

Woonsocket, RI 02895

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Project Manager/Estimator

STAFFWORKS GROUP

Attleboro, MA 02703

$75,000/yr
~ 35 min Onsite

  • Valid driver's license with a clean driving record required
  • Ability to travel to job sites in Attleboro, MA and surrounding areas
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Mental Health Therapist - Milford - Hiring Incentive Eligible

Northeast Health Services, Northeast Health Services

Milford, MA 01757

~ 19 min OnsiteBilingual PreferredHealth InsuranceRetirement Benefit

  • Possess a Master's degree in Social Work, Counseling, Marriage and Family Counseling, or a related field.
  • If required, provisional license per state regulation.
  • Educational background that leads to or has resulted in professional licensing.
  • Excellent communication skills and ability to build rapport with clients and families.
  • Ability to manage time effectively and complete documentation and administrative tasks efficiently.
  • Strong commitment to ethical practice and maintaining confidentiality.
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HRIS Administrator

MutualOne Bank

Framingham, MA 01701

New, Posted 20 hours ago
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Maintenance Technician

Advanced Recovery Systems

Worcester, MA 01604

$18-$20/hr
~ 23 min OnsiteHealth InsurancePaid Time OffRetirement Benefit

  • High School diploma or GED equivalent
  • Minimum of one (1) year experience in HVAC, plumbing, electrical, and carpentry
  • Valid state driver's license
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IT Professional

U.S. Navy

Worcester, MA 01604

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Claims Subrogation Specialist - Outbound

ACSC Management Services

Lincoln, RI 02865

$25.03-$33.34/hr
~ 26 min OnsiteEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

  • Bachelors Equivalent combination of education and experience
  • 1-3 years 1+ year(s) of claims liability experience required. Required
  • Property and Casualty Insurance License, valid in selling state - Issued by State in Texas Required
  • Typing/keyboarding/mousing proficiency required. (High proficiency)
  • Proficient in Microsoft Office suite, claims systems, appraisal systems, and E Subro Hub. (High proficiency)
  • Proficiency in Organization and Planning skills is required to manage recovery timelines. (High proficiency)
  • Advanced interpersonal skills for carrier-to-carrier negotiations. (Medium proficiency)
  • Knowledge of claims administration best practices, negligence laws, and subrogation principles. (Medium proficiency)
  • Excellent written communication skills, specifically for drafting arbitration contentions. (Medium proficiency)
  • Previous experience with ESH (E Subro Hub) preferred. (Medium proficiency)
  • Identify and obtain necessary documentation, including police reports and repair estimates, to support liability arguments and recovery demands.
  • Negotiate settlements within an established write-off authority of up to a specified dollar threshold.
  • Communicate and interact with third-party insurance carriers to negotiate and resolve subrogation demands effectively.
  • Maintain accurate records in claims, appraisal, and arbitration systems to track productivity, recovery rates, and file quality.
  • Proactively contact insured members to provide status updates on subrogation efforts, particularly regarding the status of their deductible recovery.
  • Prepare and file intercompany arbitration contentions through Arbitration Forums (Arb Forums) when negotiations reach an impasse.
  • Evaluate and determine liability for carrier-to-carrier files across multiple markets (excluding NH, VT, and KY).
  • Coordinate with internal departments as required to facilitate the recovery process.
  • Perform duties in an in-office environment as required.
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Field Service Engineer/Technician

Matec Instrument Companies

Northborough, MA 01532

New, Posted 1 day ago
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Licensed Independent Clinical Social Worker (LICSW) - Remote Opportunity at Revelation Counseling Services

Revelation Counseling Services

Grafton, MA 01519

$80,000-$100,000/yr
RemoteFlexible Schedule
New, Posted 9 hours ago
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Patient Financial Services Representative/Hospital Billing

South Shore Health

Braintree, MA 02184

~ 58 min Onsite

  • Candidates must reside in MA, RI, CT or NH to be considered
  • Position is based in Weymouth, MA
  • Knowledge of healthcare billing, insurance plans, codes, and reimbursement methodologies
  • Proficiency in data entry and basic computer skills, including Microsoft Office Suite
  • Excellent organizational and multitasking skills
  • Strong interpersonal and communication skills
  • Strong analytical and independent decision-making skills
  • Minimum Education High school graduate or above
  • Minimum Work Experience 2 years of hospital and/or physicians billing preferred
  • Hybrid or remote work options may be available
  • Notifies manager of any changes that would affect claim submission
  • Maintain compliance with federal, state, payer, and organizational billing regulations
  • Monitor payer policy updates and communicate changes that may impact billing, collections, denials, or reimbursement processes
  • Evaluates daily claim file using Claim Edit and Charge Review Work queues for submission of UB-04 and 1500 claim forms
  • Initiate claim corrections as defined payer regulation and hospital policy
  • Works external claim edits from Clearinghouse and resubmits claims through EPIC
  • Initiate collection of aged accounts receivable through Epic work queues while prioritizing accounts based on organizational goals and aging criteria
  • Unresolved and incomplete accounts require insurance company contact by phone, e-mail or designated web site to resolve outstanding balances
  • Collaborate with denial management staff for accounts that require clinical intervention for an appeal process
  • Collaborate with clinical departments, patient access and other departments as needed to resolve account issues
  • Generate technical appeals as needed for account resolution
  • Provide to manager a detail account history for any account that is considered uncollectable
  • Document all actions taken within the EPIC account notes section and/or follow up/denial activities note section
  • Documentation is required at least every 30 days for all accounts requiring follow-up
  • Escalates payer related issues to Provider Representative for resolution and participate in monthly meetings
  • Must maintain defined quality and productivity measures
  • Evaluate current processes, identify denial or payment trends and escalate to Management
  • Handle payer 277 rejections and resubmit through EPIC system
  • Reconcile account balances and ensure appropriate adjustments are applied according to established policies
  • Review credits work queues for resolution of overpayments and undistributed payments
  • Review credit balances in assigned work queues and request refunds or payer retraction as needed
  • Communicate with patients as needed for additional insurance or other information needed in order to process a claim
  • Generate phone calls or letters as needed to obtain necessary insurance or other related information, prior to an account being placed in self-pay
  • Obtain proper verification of predefined patient demographic information and maintain documentation in order to verify identity
  • Embraces technological solutions to work processes and practices
  • Uses the Mytime payroll system to enter time worked, sick days, vacations and holidays
  • Uses Epic functionality
  • Uses MS Outlook as a communication tool
  • Access provider web sites for verification of accounts
  • Access SharePoint and OneDrive for stored files
  • Fosters a “Culture of Safety” through personal ownership and commitment to a safe environment
  • Successfully answers safety questions in the annual mandatory education packet
  • Maintains a neat, organized work environment
  • Adheres to respiratory etiquette guidelines
  • Assist with identifying workflow improvements to enhance operational efficiency
  • Assist leadership with special projects, audits, and process improvement initiatives
  • Other duties as assigned by Management in accordance with department needs
  • Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization
  • Embraces technological advances that allow us to communicate information effectively and efficiently based on role
  • Complete necessary training sessions required for the Billing System and assigned accounts within Follow Up and Denial work queues
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