- Cardinal Health (Trenton, NJ)
- …company policy, regulations, or third party policy. + Updates patient files for insurance information, Medicare status, and other changes as necessary or ... right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of… more
- Humana (Trenton, NJ)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- CVS Health (NJ)
- …record systems and engaging on multiple platforms - Demonstrated understanding of insurance , Medicaid, Medicare billing requirements - Evidence of strong crisis ... intervention skills - Previous experience in a mental health clinic or hospital setting **Education** - Completed Master's degree program from an accredited College or University. - State License with one or more of the following licenses: Licensed Clinical… more
- Humana (Trenton, NJ)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Humana (Trenton, NJ)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand… more
- Humana (Trenton, NJ)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… 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 ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance... Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees for producers… more
- Virtua Health (Moorestown, NJ)
- …experience in a medical practice or ambulatory medical setting. Knowledge of insurance (ICD-9 CPT coding, Medicare regulations, state regulations, CLIA, DOH, ... regulations) preferred. Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, Medicare and managed… more
- Virtua Health (Mount Holly, NJ)
- …experience in a medical practice or ambulatory medical setting. Knowledge of insurance (ICD-9 CPT coding, Medicare regulations, state regulations, CLIA, DOH, ... regulations) preferred. Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, Medicare and managed… more
- Hackensack Meridian Health (Neptune City, NJ)
- …reviews of all Access data elements, such as real time eligibility (RTE), Medicare Payer Secondary Questionnaire (MSPQ), Insurance plan codes, proper sequencing ... of COB (Coordination of Benefits), and reviews physician licensure. Works with Access assigned Work Ques (WQs) to correct the edits causing the stop bills. Included in this is the compilation of edit findings to provide management with a tool to provide… more