- 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 managed care ... individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or ...including value based care/ACO modeling + Knowledge of group insurance products including disability, long term care, etc. The… more
- BAYADA Home Health Care (Cranford, NJ)
- …Therapist or Speech Language Pathologist should have prior experience in Medicare Home Health. This position offers the successful candidate the opportunity ... community health experience + Prior clinical and managerial experience within a Medicare Certified Home Health agency + Comprehensive knowledge of OASIS and the… more
- BAYADA Home Health Care (West Deptford, NJ)
- …quality and adherence to policies, procedures, hospice eligibility documentation, and Medicare Conditions of Participation. In this integral leadership role, you ... services rendered in accordance with policies and procedures and Medicare rules + Serve as a key medical resource...vision, dental and medical health plans, employer paid life insurance , 401k with company match, direct deposit and employee… more
- Ascendis Pharma (Princeton, NJ)
- …administration of rebate programs, including government rebates (eg, Medicaid, Medicare ), managed care rebates, and commercial rebates. Ensure accurate calculation, ... and contracting strategies across various payer segments (eg, commercial, Medicare , Medicaid). + Excellent negotiation, communication, and interpersonal skills, with… more
- Sedgwick (Trenton, NJ)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive | Remote As a Claims ... Injury General Liability Claims Examiner** working within **commercial (** **captive) insurance program(s)** ? Are you skilled in **coverage determination** ,… more
- Cardinal Health (Trenton, NJ)
- …with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and ... timely access to necessary services + Assist in obtaining insurance , prior authorization, and appeal requirements and outcomes + Help patients understand their … more
- Sedgwick (Trenton, NJ)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claim Examiner - Liability **PRIMARY PURPOSE** : To analyze complex or technically ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …forecast * Monitor and track claims data for Commercial, Medical Commercial, Medicaid, Medicare , 340B and other government segments to changes to business mix and ... forecasting including understanding various payer channels (Commercial, Medical commercial, Medicare , Medicaid, PHS340b, VA/DoD, Tricare, etc.) * Working knowledge… more
- Sedgwick (Newark, NJ)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance General & Product Liability Complex Claim Examiner - Multi-State Preferred - ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
- Atlantic Health System (Morristown, NJ)
- …issues, including fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid compliance, licensure issues, pay-to-play issues, corporate governance ... committees, work groups and task forces. Work collaboratively with Risk Management, Insurance , Privacy, Audit & Compliance and other key functional areas to align… more