- 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
- 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
- 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
- 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
- Walgreens (Edison, 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
- Walgreens (Princeton, 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
- Cardinal Health (Trenton, NJ)
- …to patient inquiries in a professional and timely manner. **_Responsibilities:_** + Review aging reports and work patient accounts to ensure timely resolution and ... billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs)… 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
- Cardinal Health (Trenton, NJ)
- …payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with insurance carriers for reimbursement ... + Consults with appeals department for disputed / denied claims . + Works / Understands electronic claim interchange +...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Walgreens (Ewing, NJ)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist has the ultimate responsibility for ensuring that… more
- Hunterdon Health Care System (Flemington, NJ)
- …at the HMC Business Office and will be assigned to report to a Supervisor within the Business Office. The position is responsible for working collegially with the ... an efficient system for the daily electronic submission of claims , identifying errors and making the necessary corrections to...on a daily basis. + Works with the Billing Supervisor to develop and implement bill edits and prevent… more
- Amcor (Somerville, NJ)
- …safety training information for weekly department/shift meetings. 5. Conduct quarterly Supervisor /Groupleader safety reviews and annual Manager safety review . 6. ... www.amcor.com | LinkedIn | YouTube **Responsibilities** **Major Responsibilities** As Manager/ Supervisor exemplify the organization's values of partnerships, excellence, growth… more
- CVS Health (Trenton, NJ)
- …distribution of the monthly premium invoices. The Billing Premium Consultant must review invoices for reasonability and accuracy and make any necessary adjustments ... billing systems. + Execute monthly invoices on appropriate billing platform and review group specifications to ensure all appropriate information is included with… more
- CVS Health (Trenton, NJ)
- …to enhance a member's overall wellness. * Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. * Applies clinical ... * Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… more
- Walgreens (New Brunswick, NJ)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. **Communication** + Communicates with pharmacy… more