- CVS Health (Trenton, NJ)
- …it all with heart, each and every day. **Position Summary** + The Medicaid VBS Network State Manager manages and oversees compliance with our Network ... responsibilities as provided within the State Medicaid contractual requirements as outlined below: + Accountable for working with our strategic provider partners to… more
- SERV Behavioral Health System (Hamilton, NJ)
- …ensure timely client admissions and meet occupancy goals; + Ensures clients maintain Medicaid /Medicare eligibility and funding under the fee for service system. ... + Establishes and maintains positive relationships with external partners including case managers, support coordinators, families, schools, law enforcement, local governments and state oversight entities; builds strong community relationships; + Supports the… more
- Atlantic Health System (Morristown, NJ)
- …to patients and family members. Handles inquiries from patients regarding the eligibility for Medicaid . Assists applicants with required paperwork, ... eligibility requirements and counseling on Medicaid guidelines. Collects money owed from patients and third-party...for at-risk patients to receive care. + Verifies insurance eligibility when applicable. Informs patient of payment options and… more
- Hackensack Meridian Health (Tinton Falls, NJ)
- …or office appointment) or by phone. Directly responsible for accurately processing Presumptive Eligibility (PE) Medicaid and for the follow up process to ensure ... are under insured for State of New Jersey (NJ) Medicaid , State of NJ Charity Care or State of...**Licenses and Certifications Required** : + Must pass Presumptive Eligibility (PE) certification at hire, as well maintain any… more
- Sevita (Delran, NJ)
- …and third-party service providers. + Assist individuals with related matters including eligibility for benefits through Medicaid , Medicare, Social Security, and ... private insurance. + Maintain up-to-date case records with the status of case activity, including progress notes on all contacts. **_Qualifications:_** + Bachelor's degree in human services or equivalent in education and experience required. + Minimum of 1… more
- CVS Health (Trenton, NJ)
- …multiple health plan clients across multiple lines of business including Medicare, Medicaid , Exchange, and Commercial. This is a remote role, open to qualified ... understanding of CVSH clinical portfolio, marketplace segments dynamics (Medicare, Medicaid , Exchange, and or Commercial) and industry trends + Demonstrated… more
- Ascendis Pharma (Princeton, NJ)
- …of monthly, quarterly, and annual GP reports to CMS, VA/DoD, and state Medicaid agencies, and any programs requiring price reporting, per legislative requirements + ... programs + Deep expertise in US Federal and State Pricing Programs ( Medicaid , Medicare, VA/DoD, PHS/340B) and related regulations. + Expertise in GP reporting… more
- Conduent (New Brunswick, NJ)
- …providing clear and courteous information about program benefits, enrollment, and eligibility . Assists beneficiaries with application completion and eligibility ... a call center environment using standard scripts and procedures. + Enters eligibility information into a web-based computer system and references other NJ-specific… more
- Cognizant (Trenton, NJ)
- …features. * Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory requirements. **Work Model:** We strive to… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …Perform an initial screening/verification of benefits according to Medicare, Medicaid , and third-party payor guidelines, coordinate equipment with contracted ... gathered accurately into HCHB. + Contact the insurance company for eligibility and authorization. Obtain sufficient client and insurance information to confirm… more