- Datavant (Trenton, NJ)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum Education: LVN/LPN +… more
- Elevance Health (Morristown, NJ)
- …members and providers. **How you will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and ... supportive care. + Perform physician-level case review, following initial nurse review, of chemotherapy regimens. + Determine medical necessity of requests using… more
- Hackensack Meridian Health (Red Bank, NJ)
- …promotes appropriate clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, Health Information Management ... documentation for severity of illness and medical necessity. Interacts with physicians, case managers, and nursing staff and provides guidance and… more
- Datavant (Trenton, NJ)
- …quality, compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role, you will ... and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution. + Demonstrate versatility and exceptional work across a wide… more
- Ethos Veterinary Health (Red Bank, NJ)
- …have the opportunity to develop advanced skills in oncology patient management , work closely alongside veterinary oncologists, and contribute to delivering ... Tuesday - Friday + 8am-6pm + Rotating Saturdays required Key Responsibilities: Nursing Responsibilities + Provide comprehensive nursing care for both outpatient… more
- Travelers Insurance Company (Trenton, NJ)
- …service on assigned claims, while engaging in indemnity & expense management . Promptly manage claims by completing essential functions including contacts, ... investigation, damages development, evaluation, reserving, litigation management , negotiating and resolution. Provides consulting and training and serves as an… more
- Hackensack Meridian Health (Little Falls, NJ)
- …sources, provide hospice education to patients and families, perform nursing assessments to determine hospice eligibility, coordinate hospice admission process ... and collaborate with the hospice team. + Referral management : Respond timely to referral requests from facilities, hospitals, and other health care providers. +… more
- Datavant (Trenton, NJ)
- …productivity benchmarks + Foster professional communication with colleagues, management , and hospital staff, while addressing clinical and reimbursement ... Stand Out:** + Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AHIMA/AAPC with a… more
- Hackensack Meridian Health (Wall, NJ)
- …information and plan of care is communicated in a timely manner to primary nurse and appropriate team members. Conduct case conferences throughout care and ... + Report patient care problems, along with possible solutions, to primary care nurse or appropriate social work management personnel. Communicate with supervisor… more
- Travelers Insurance Company (Morristown, NJ)
- …process, relevant case and statutory law and expert + litigation management skills preferred. + Extensive claim and/or legal experience and technical expertise ... life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management , negotiation and resolution) including maintaining full compliance with… more