- Highmark Health (Trenton, NJ)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... include legislators, consumers, special interest groups, advocacy agencies, CMS, state Medicare /Medicaid administrators, and other regulatory bodies such as DPW. +… more
- Intermountain Health (Trenton, NJ)
- …referral information, entering data into the Electronic Medical Record (EMR), and verifying insurance benefits or self-pay status at the time of intake. + Manages ... knowledge, addressing concerns promptly while maintaining a working understanding of Medicare , Medicaid, and third-party billing requirements, as well as privacy and… more
- Actalent (Leonia, NJ)
- …Responsibilities + Utilize Bright Tree System to navigate NJ HMO websites, commercial insurance portals, and Medicare systems. + Contact insurance providers ... + Bilingual in Spanish/English preferred Additional Skills & Qualifications + Prior insurance verification experience ( Medicare , Medicaid, private insurance )… more
- Humana (Trenton, NJ)
- …of the responsibilities: + Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if ... part of our caring community and help us put health first** The Senior Agency Management Professional provides support...the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance… more
- Hunterdon Health Care System (Flemington, NJ)
- …to assure timely billing and appropriate reimbursement from Non-Governmental Insurance Companies. Primary Position Responsibilities + Utilize tools, software and ... and prior experience working in a customer service environment. Experience with Medicare Rules, DRG/APC payment methodology. + License, Registry or Certification : +… more
- Deloitte (Jersey City, NJ)
- …Required: + 5+ years of health actuary experience and consulting and/or health plan/ insurance company experience + 2+ years of experience with Medicaid ... public entities + Participate in the transformation of the health care sector through innovative actuarial solutions, such as...individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or … more
- Humana (Trenton, NJ)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + PharmD + Health Plan experience + Knowledge of Medicare as it relates ... part of our caring community and help us put health first** Be a part of an interactive team...well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data ... + 3+ years of SQL experience, preferably in SSMS. **Preferred Qualifications** + Medicare Advantage experience. + Experience with SQL and VBA highly preferred. +… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data ... expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes: + Owning and improving our ESRD claims… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and ... This role will support a few tools used within our Individual Medicare Advantage pricing and internal reporting process. This includes: + Helping make… more