- NJM Insurance (Hammonton, NJ)
- …legal proceedings as appropriate. + Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation. ... NJM's General Claims Legal department is seeking a PIP Appeal...Job Responsibilities: + Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures.… more
- Advanced Orthopedics and Sports Medicine Institute (Freehold, NJ)
- …be documented with current status and strategy to bring claim to closure. Compile claims data and update logs, tracking and trending reports and communicate ... time ( on -site ) Monday - Friday The AR Billing and Collection Representative II is responsible for analyzing assigned past due accounts and coordinating between… more
- Highmark Health (Trenton, NJ)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- CVS Health (Trenton, NJ)
- …team, and measuring success through improved member health as evidenced through Data Analytics. + Assists the customer's Wellness Representative (s) in managing ... navigating them through the health system, providing support on claims issues, and answering coverage-level questions. **We have two...the employees and the customer Total Rewards team on appeals . + Assist the Total Rewards team with the… more