- The Center for Great Expectations (North Brunswick, NJ)
- …process for new clients and forwards to finance for insurance review & eligibility verification. * Completes EMEVS check for Medicaid clients; downloads and ... required client documents on day of intake. * Completes Medicaid presumptive eligibility . * Uploads phone referral form and other preadmission documentation… 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
- CenterWell (Trenton, NJ)
- …community and help us put health first** A **Director of Authorizations & Eligibility ** is a senior revenue cycle leader responsible for the strategic oversight, ... operational execution, and continuous improvement of all authorization, insurance eligibility re-verification and payer maintenance for a large, complex Home Health… more
- Hackensack Meridian Health (Hackensack, NJ)
- …obligations and providing related education. + Bilingual in Spanish. + Familiar with eligibility requirements for NJ Medicaid and Charity Care. **Licenses and ... Certifications Preferred:** + Presumptive Eligibility (PE) Certification. + Epic Hospital Billing (HB) Certification. If you feel that the above description speaks… 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
- CVS Health (NJ)
- …developing and maintaining complex financial reporting solutions that support Aetna's Medicaid Markets. This role will lead reporting for Value-Based Service ... tables, formulas, and graphs. **Preferred Qualifications** + Experience working with Medicaid and Medicare programs. + Advanced Excel skills (complex formulas,… more
- Cognizant (Trenton, NJ)
- …Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid , and private insurance plans. + _Adjudication:_ Approve, deny, or ... equivalent REQUIRED + Strong knowledge of US healthcare insurance systems (Medicare, Medicaid , commercial payers). + 2-4 years of experience in US healthcare claims… more
- Baylor Scott & White Health (Trenton, NJ)
- …to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends ... to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource...on your journey. For full details on coverage and eligibility , visit the Baylor Scott & White Benefits Hub… 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