Top Tech Jobs & Startup Jobs in Boston, MA

Review and process appeal mail intake within the HUB appeals unit, assist higher-level auditors on field work, complete appeals-related tasks (position papers, jurisdictional reviews), maintain accurate logs/case files, respond to customer inquiries, analyze data and recommend changes, participate in team meetings and continuing education.

Manage state-level provider database staff and workflows, oversee provider loading/audits and troubleshooting, liaise across functions to resolve enrollment and data flow issues, and hire/train/coach direct reports to ensure consistent provider data integrity.

Reviews and processes Medicare cost reports for Part A providers, including acceptance, interim rate reviews, tentative settlements, and final settlements. Interprets federal regulations and reimbursement data, responds to inquiries, recommends changes, manages assigned projects, and maintains accurate reimbursement. The role requires continuing education and familiarity with CMS regulations, cost report formats, CMS systems, and Microsoft Office.

Perform and supervise complex Medicare cost report desk reviews and audits, prepare work papers per Government Auditing Standards and CMS requirements, analyze reimbursement data, handle appeals and exception requests, mentor junior staff, participate in special projects, and support CMS contractual workload with occasional travel and required training.

Review paid claims to identify and validate overpayments, calculate amounts, process refunds and claim adjustments, research voluntary refunds, balance accounts, perform collection activities, and collaborate with internal teams to maintain cash application and accounts receivable accuracy.

Validate paid claims for overpayments, calculate and process refunds, research voluntary refunds, balance accounts, perform collections and cash application tasks, and collaborate with internal teams to resolve routine claim and payment issues.