- Serenity Hospice Care (Bordentown, NJ)
- …between interdisciplinary team members, patients, and families. Responsibilities: + Review clinical documentation for accuracy, completeness, and compliance with ... hospice policies and Medicare guidelines. + Support triage functions by responding to...is highly desirable. + Knowledge of hospice regulations and Medicare /Medicaid guidelines. + Proficiency in EMR systems and Microsoft… more
- Hackensack Meridian Health (Neptune City, NJ)
- …admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status. ... Knowledge of Pathophysiology and Disease Process. + Knowledge of Medicare Part A. + Familiar with Medicare ...of Medicare Part A. + Familiar with Medicare Part B. + Knowledge of regulatory environment. +… more
- Option Care Health (Morris Plains, NJ)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...using find and replace, undo, spell check, track changes, review pane and/or print functions). + Basic level skill… more
- WTW (Fort Lee, NJ)
- …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... production accounting, invoicing approvals, legal/SOW management, and budget adherence. + ** Review and approve talent background checks,** ensuring all talent meets… more
- Hackensack Meridian Health (Eatontown, NJ)
- …utilizing on-line or by phone when required. Has current knowledge of Medicare reimbursement criteria and insurance contracts for Hackensack Meridian Health product ... recognize and establish priorities to make maximum use of downtime. + Review and confirm all deliveries. Review all open orders on a daily basis. Run Open Order… more
- RWJBarnabas Health (New Brunswick, NJ)
- …Nursing Preferred: + Case Management certification preferred. + Utilization review and/ or discharge planning experience preferred. Certifications and Licenses ... and every other weekend Essential Functions: + Discharge planning and clinical review for an assigned group of inpatients to determine appropriateness utilizing… more
- Sunrise Senior Living (Edison, NJ)
- …Care Plan process and required documentation. + Facilitate the Triple Check and Medicare meetings weekly. + Ensure billing information is available for the Business ... Office to submit to Sunrise CSO on a timely basis. + Review clinical documentation in the guest/resident health information record routinely for accuracy and… more
- Virtua Health (Marlton, NJ)
- …pain/symptom management. Re-certifying patients, as appropriate, for continuation of the Medicare Hospice Benefit at the appropriate levels of care. Assures overall ... supplies. Participate and provide clinical leadership in the development and review of appropriate clinical protocols and processes that support appropriate patient… more
- Fresenius Medical Center (Vineland, NJ)
- …the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ... or state specific certification as defined by Center for Medicaid/ Medicare Services (CMS)Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization… more
- Humana (Trenton, NJ)
- …They will develop and maintain team best practices such as peer review and documentation. The Lead Actuary will be responsible for Medicaid-specific functions ... such as capitation rate review , drafting rate advocacy communications, actual-to-expected business analytics, forecasting market-specific financial results, and many… more