- Hackensack Meridian Health (Eatontown, NJ)
- …for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine ... in the system if inappropriate codes are identified. + Review each Hospice assessment to assure each CTI, 485...in collecting information for accurate and timely coding. + Review HIS to assure an accurate reflection of the… more
- St. George Tanaq Corporation (Trenton, NJ)
- …Experience and Skills** + Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare ... college or university in healthcare or related discipline. Additional experience in Medicare appeals, medical review , clinical, or other related experience in… more
- St. George Tanaq Corporation (Trenton, NJ)
- …Requirements **Required Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, ... college or university in healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience in… more
- RWJBarnabas Health (Oceanport, NJ)
- Inpatient Coding Quality Officer III - ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services ... integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher...a team with other Quality Officers to ensure SMART review goals are met for all RWJBarnabas facilities. +… more
- Humana (Newark, NJ)
- …exceed $120K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability ... as well as, visiting prospects in their homes. Our ** Medicare Sales Field Agents** sell individual health plan products...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… more
- Humana (Trenton, NJ)
- …of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative ... established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be passionate about… more
- Humana (Trenton, NJ)
- …first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on ... clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate about contributing… more
- Specialty Rx, Inc. (Ridgefield Park, NJ)
- Job Description SpecialtyRx is a full-service pharmacy. We need Medicare Part B- Billing Representative with Pharmacy experience in our Ridgefield Park, NJ location. ... and benefits package. Responsibilities: + Experience with billing Part B claims, review and handle denials. + Knowledge with vaccine billing, including Covid. +… more
- Humana (Trenton, NJ)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will...daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, … more
- Humana (Trenton, NJ)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more