- Trustmark (Trenton, NJ)
- …our colleagues, clients and communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & ... of claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy, policy provisions… more
- NJM Insurance (Trenton, NJ)
- NJM is seeking a Workers' Compensation (WC) Claims Specialist (I/II/ Sr .) . This is a full-time position and offers a hybrid schedule after training with a ... can vary depending on start time). Responsibilities: + Ensure quality management of claims in accordance with...and WC regulations for PA, CT, MD and/or DE claims . + Sr Level - 5+ years'… more
- Deloitte (Philadelphia, PA)
- …who wants to work in a collaborative environment? As an experienced Epic Billing and Claims Senior Analyst you will have the ability to share new ideas and ... configuration and builds by maintaining industry and client standards ensuring build quality and timeline adherence as well as debugging and resolving any… more
- Intermountain Health (Trenton, NJ)
- …of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as ... hospital personnel as needed. + Acts as a mentor. As assigned, coordinates training , direction and review of those working with reimbursement functions. + Manages… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- The Sr . Manager Quality Management System is responsible for monitoring the effectiveness of the GxP Quality Management Systems regarding CAPA, Deviations, ... metrics and KPIs periodically for reporting. Leads the local Quality Review Team to provide guidance and training...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- CenterWell (Trenton, NJ)
- …**Key Responsibilities:** + **Operational Reporting:** Oversee the medical and prescription claims processes, including quality , audits, and reporting. Manage ... community and help us put health first** As a Sr . Business Intelligence Engineer for CenterWell Primary Care, you...operations & BI reporting and a passion for data quality and process improvement. The ideal candidate will have… more
- Prime Therapeutics (Trenton, NJ)
- …our passion and drives every decision we make. **Job Posting Title** Senior Health Outcomes Researcher - Remote **Job Description** The Health Outcomes Researcher ... focused on drug utilization, combined medical and pharmacy drug claims , with a view to the impact on patient...of Principal Health Outcomes Researcher, Principal Data Scientist, or Sr Dir Health Outcomes, define and document complex study… more
- Cherry Bekaert (Trenton, NJ)
- **Description** **Summary of Responsibilities:** The Senior Associate will work closely with the Cherry Bekaert FAO (Finance & Accounting Outsourcing) team, ... for our clients in the insurance, service and related industries. The Sr . Associate will also assist in an administrative project management capacity, spearheading… more
- United Therapeutics (Trenton, NJ)
- …practices, you drive a culture of compliance with confidence and enthusiasm. The Senior Corporate Compliance Manager - Training , Communications and Policy will ... experiences. Detail-oriented yet creative, you balance policy management with innovative training strategies that resonate across all levels of the organization. You… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission ... considerable latitude in determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims… more
- Atlas (Burlington, NJ)
- …at any and every step of the project, and with a heart-led approach that puts quality and safety at the center of everything we do. We're just built to be better. ... Description** Atlas is looking for someone to join our Legal Team as ** Senior Litigation Counsel (Engineering / Construction)** to be located in one of our… more
- Guidehouse (Philadelphia, PA)
- …or a similar quantitative discipline. + Experience integrating multiple commercial and claims datasets to generate enhanced / high- quality insights. + Experience ... You Will Do** **:** We are looking for a Senior Consultant to join our Life Sciences team, which...include but are not limited to medical and pharmacy claims (open and closed), formulary and managed care data,… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …Health Care** is currently seeking a full-time Reimbursement Services (Operation) Senior Manager! This is a REMOTE opportunity! POSITION SUMMARY: Provides management ... accurate production of bills along with the collection of outstanding invoices and claims . Responsible for the direct supervision of staff within the assigned unit.… more
- Walgreens (Philadelphia, PA)
- …certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. + Attends training and completes PPLs requested ... and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the Walgreen...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- CenterWell (Trenton, NJ)
- …of our caring community and help us put health first** The Senior Pharmacy Contracting Professional is responsible for reporting, implementation, and maintenance of ... Humana's Healthy Horizon Medicaid business. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to complex issues where the… more
- Endo International (Cranbury, NJ)
- …work to bring the best treatments forward. Our shared values of Integrity & Quality , Innovation, Drive, Collaboration and Empathy guide our team and enable us to ... everyone we serve live their best life. **Job Description Summary** The Senior Buyer/Planner, Production Planning is responsible for analyzing and responding to… more
- Humana (Trenton, NJ)
- …of our caring community and help us put health first** The Senior Financial Reporting Professional/ Analyst prepares and distributes periodic financial statements ... other than those directly employed by the organization. The Senior Finance Reporting Professional/ Analyst + Analyzes and forecasts...all business areas such as: Finance, Network, Health Services, Claims and Actuarial **Use your skills to make an… more
- Prime Therapeutics (Trenton, NJ)
- …passion and drives every decision we make. **Job Posting Title** Senior Functional Business Consultant/ Regulatory Compliance exp required- REMOTE **Job ... analysis, complex issue research, documentation, advanced communications, client interaction, training , testing, ongoing system support, and developing reports and… more
- Highmark Health (Trenton, NJ)
- …of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care ... actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to… more
- Carrington (Cherry Hill, NJ)
- …pay for this position is $31.73 an hour. **What you'll do:** * Provides training , creates and updates Policy & Procedures, and reviews control reports to ensure ... overall quality and performance of the Bankruptcy processes * Handles...with recommendations and solutions. * Conduct informal and formal training sessions with the staff on the bankruptcy processes.… more