- Lincoln Financial Group (Trenton, NJ)
- …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
- BAYADA Home Health Care (Pennsauken, NJ)
- POSITION SUMMARY: BAYADA Home Health Care is seeking a Healthcare Billing Associate to work in our Enterprise Reimbursement Services office in our state of the ... art facility in Pennsauken, NJ. This role is currently remote with the expectation that you will go into...your career and learn the business? Then the Reimbursement Associate position might be right for you! This is… more
- Humana (Trenton, NJ)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- Marriott (Trenton, NJ)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- Humana (Trenton, NJ)
- …more years of experience with CMS and/or AHCA compliance + 2 or more years Claims experience + 2 or more years Audit and/or Financial Recovery experience + SQL ... structure and design **Preferred Qualifications** + Direct experience working with Medicare claims + Working knowledge of CPT, ICD10 and HCPC + Provider contract… more
- Humana (Trenton, NJ)
- …first** Humana's Clinical Analytics Team is seeking a Senior Research Scientist ( Remote ). Our team identifies opportunities and builds solutions to improve clinical ... improvement for our members. + Develop models and/or rules using clinical condition in claims data, membership data, or other data sources in order to target at-risk… more
- Humana (Trenton, NJ)
- …team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical ... depth of knowledge of administrative processes and organizational knowledge. **This is a remote position from anywhere in the US.** **What Humana Offers** We are… more
- PSEG (New Providence, NJ)
- …come with being a Fortune 500 company, as well as the attention, camaraderie and care for one another you might typically associate with a small business. Our ... hybrid roles that are a blend of onsite and remote work, remote local roles that are...directed; + Preparing accident reports and computing charges for claims ; + Classifying and checking time sheets; maintaining payroll… more
- Humana (Trenton, NJ)
- …Disputes reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The ... **What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company...opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent… more
- Elevance Health (Morristown, NJ)
- …Practice Enablement Clinician** **Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from one ... key strategic solutions that involve practice collaboration and enablement to improve member care quality and value. Serves as a strategic solution lead for Oncology… more
- Humana (Trenton, NJ)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Trenton, NJ)
- …+ Intermediate to advanced experience in programming, analytical work, and with claims data. + Familiarity or prior experience with data governance and literacy. ... requirements and guidelines. **Additional Information** + **Travel** : None + **Workstyle:** Remote + **Core Workdays & Hours:** Typically, 8-5 pm Monday - Friday;… more
- Humana (Jersey City, NJ)
- …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more
- Humana (Trenton, NJ)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more