- Novo Nordisk Inc. (Plainsboro, NJ)
- …& Contracting, and other field and home office stakeholders. External relationships include Managed Care & Medicare customers, Market Access and System Vendors. ... with external source for loading and scrubbing of rebate claims data Works with external vendor and customer to resolve data issues Provides support for… more
- Novo Nordisk (Plainsboro, NJ)
- …& Contracting, and other field and home office stakeholders. External relationships include Managed Care & Medicare customers, Market Access and System Vendors. ... with external source for loading and scrubbing of rebate claims data + Works with external vendor and customer to resolve data issues + Provides support… more
- Humana (Trenton, NJ)
- …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
- HealthEdge Software Inc (Trenton, NJ)
- …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
- Takeda Pharmaceuticals (Trenton, NJ)
- … Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- St. Luke's University Health Network (Allentown, PA)
- …necessity, and other requested denials as deemed clinically appropriate. + Investigates managed care and commercial insurance rejections, denials for possible ... which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses...Provides billing with information needed to obtain payment of claims . Remote within local geography after orientation. JOB DUTIES… more
- Humana (Trenton, NJ)
- …experience with mid-size projects. + 2+ years of experience working with managed healthcare contracts, including an understanding of provider contract language. + ... and/or Medicaid health plan operations, such as provider relations, claims submission and payment, utilization management processes, behavioral health processes,… more
