- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Review makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Supervisor , Claims Review works within thorough, prescribed guidelines and… more
- Sedgwick (Trenton, NJ)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and… more
- Raphael and Associates (Rutherford, NJ)
- …in-office position located at our Rutherford, NJ, headquarters. Key Responsibilities: + Initial Claims Setup: + Review FNOL (First Notice of Loss) and ensure ... and organized individual to join our team as a Claims Setup Specialist. This entry-level role is focused on...+ Assign the claim to the appropriate adjuster and supervisor . + Set adjuster diaries with new claim notifications… more
- Sedgwick (Trenton, NJ)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Advisor, Environmental | Professional Liability | REMOTE **Job Description Summary** ... To analyze complex or technically difficult environmental claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
- Carrington (Cherry Hill, NJ)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses ... this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE...manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but… more
- Ryder System (Trenton, NJ)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- System One (Lakewood, NJ)
- Job Title: Quality Assurance Supervisor Location: Lakewood, NJ Type: Contract To Hire Compensation: $25-$32/hr. (can be flexible based on experience) Contractor Work ... 8 am to 4:30 pm We are seeking a proactive and experienced Quality Assurance Supervisor to lead our QA program and ensure that all products, materials, and processes… more
- Travelers Insurance Company (Morristown, NJ)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle ... **What Will You Do?** + Directly handle assigned severe claims . + Full damage value for average claim (without...documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality… more
- Raphael and Associates (Rutherford, NJ)
- …details, and assigning claims to the appropriate adjusters. Key Responsibilities: + Initial Claims Setup: + Review FNOL (First Notice of Loss) and ensure all ... and organized individual to join our team as a Claims Setup Specialist. This entry-level role is focused on...+ Assign the claim to the appropriate adjuster and supervisor . + Set adjuster diaries with new claim notifications… more
- Travelers Insurance Company (Morristown, NJ)
- …reserving, negotiating and resolving assigned serious and complex General Liability claims . Provides quality claim handling throughout the claim life cycle (customer ... Do?** + CLAIM HANDLING: + Directly handle assigned severe claims when Travelers has coverage of $2 million or...documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality… more
- NJM Insurance (Trenton, NJ)
- …to the Workers' Compensation (WC) Training and Quality Assurance Management Supervisor , the WC Quality Assurance/Compliance Analyst is responsible for ensuring ... as audit program development and file selection, assuring the review process is proper and timely. + Conduct WC...data integrity, compliance, and best practices. + Collaborate with claims management in the development of meaningful action plans… more
- Shuvel Digital (Lawrenceville, NJ)
- …to make corrections and ensures accuracy for the days work. + Researches all utilization review claims for accuracy prior to billing on a timely basis. + ... GED. Experience: ESSENTIAL FUNCTIONS + Ensures responsibility to download claims from HBOC and upload claims to...+ Reports any trends and anomalies to Patient Accounts Supervisor and Patient Accounts + Manager in a timely… more
- NJM Insurance (Trenton, NJ)
- …tools. + Collect and report audit findings. + Consolidate data into report for supervisor review . + Identify trends or patterns. + Perform pre- and post-payment ... Reporting to the QC Supervisor , the Quality Control & Compliance Associate is...compliance checklist reviews for both PIP and Workers' Compensation Claims . Essential Duties and Responsibilities: + Assist the QC… more
- Cardinal Health (Trenton, NJ)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... receivable and increase cash flow for the organization. **_Responsibilities:_** + Review aging reports and work insurance accounts to ensure timely resolution… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …+ Complete claim denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways to prevent claims ... denying. + Process balance transfers, adjustment requests, refunds and corrected claims as part of accounts receivable management responsibilities. + Complete… more
- Walgreens (Northfield, NJ)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels patients and answers questions ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist is responsible for ensuring that elements of… more
- Legacy Treatment Services (Marlton, NJ)
- …Must be able to understand and read the Explanation of Benefits (EOB). Review all open charges for non-payment, short payment ineligibility, inaccurate diagnoses, no ... of services. Responsible for appealing all of the unpaid and denied claims received. Complete all corrections in CareLogic and document process. Communicate… more
- Walgreens (Howell, NJ)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and assists in community events as requested by Store Manager, Healthcare Supervisor , District Manager or Pharmacy Manager. **Operations** + Under direct supervision… more
- The Falcon Group (Warren, NJ)
- …(in deposition and trial) specifically for community association transitions, construction, claims and ensuring the successful delivery of projects within scope, ... accurate data collection for accurate interpretation of results. + Performs peer review of other technical data prepared by internal Engineers/Architects as well as… more
- Walgreens (Oakland, NJ)
- …the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more