- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Atlantic Health System (Union, NJ)
- + Monday-Friday, 8:30 AM - 4:30 PM + 3 providers -2 MDs and 1 Nurse Practitioner + Summit and Morristown Seeking a detail-oriented nurse with experience in ... medication and imaging prior authorizations, appeals management, and completion of disability forms. The ideal candidate will be proficient in initiating and… more
- BelovED Community & Empowerment Academy Charter Sc (Jersey City, NJ)
- …three campuses, an Elementary School, Middle School, and High School. We are hiring a School Nurse to serve all of our students. You will be working on a team fo 4 ... Jersey City, Hoboken and New York City. If this appeals to you, then apply today! We have achieved...Jersey. Requirements + The Candidate needs to possess School Nurse certification in New Jersey. (We would consider someone… more
- Hackensack Meridian Health (Neptune City, NJ)
- …transform healthcare and serve as a leader of positive change. The **Registered Nurse ** Non-Acute functions as a caregiver for a specific patient population in order ... assisting the LPNs, MDs, and NPs with their inboxes, medication appeals , prescription/lab/imaging ordering, etc. The office is open Monday-Friday 8:30am-5:00pm, no… more
- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... communication with management regarding billing and coding issues including documentation, denials/ appeals , etc.* Follows up on assigned insurances on a monthly… more
- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... communication with management regarding billing and coding issues including documentation, denials/ appeals , etc. * Follows up on assigned insurances on a monthly… more
- Sharecare (Trenton, NJ)
- …enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical, ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status +...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Virtua Health (Moorestown, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... testing results coordination, as well as pre-certification/insurance status and appeals . Coordinates the administrative flow of the patient experience. Reports… more
- Hackensack Meridian Health (North Bergen, NJ)
- …information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and ... management **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP Certification.… more