- CenterWell (Trenton, NJ)
- …our caring community and help us put health first** The Manager of Pre -Bill Audit provides strategic leadership and operational oversight for the organization's ... pre -billing function. This role is responsible for ensuring all claims are audit-ready prior to release, driving standardization across branches, and delivering… more
- Humana (Trenton, NJ)
- …+ Previous encounter submissions experience + Prior internship or experience in healthcare data management, claims processing, or actuarial services + Working ... knowledge of Microsoft SQL or SAS + Understanding of healthcare encounter data and basic knowledge of claims submission and reconciliation processes. + Strong… more
- Humana (Trenton, NJ)
- …Excel (pivot tables, VLOOKUP, formulas) + Familiarity with Medicaid systems, claims platforms, and reconciliation tools **Work-At- Home Requirements** + At ... existing Medicaid business processes, with a focus on eligibility, enrollment, claims , and compliance workflows. This role develops sustainable, repeatable, and… more
- University of Pennsylvania (Philadelphia, PA)
- …and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play. The University offers a competitive benefits package that ... includes excellent healthcare and tuition benefits for employees and their families,...programming skills to create analytical datasets from health care claims , administrative databases, clinical trials, and surveys to construct… more
- Humana (Trenton, NJ)
- …escalations. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home . While this is a remote position, occasional travel to Humana's offices for ... certification experience utilizing coding guidelines by reading and interpreting claims + Exceptional understanding of Centers for Medicare &...hours are 8AM - 5PM Eastern time. **Work at Home Requirements** * At minimum, a download speed of… more
- University of Pennsylvania (Philadelphia, PA)
- …and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play. The University offers a competitive benefits package that ... includes excellent healthcare and tuition benefits for employees and their families,...Description Job Responsibilities + Responsibilities of this position include pre -reviewing submissions assigned to the convened CTSRMC for completeness… more
- Evolent (Trenton, NJ)
- …seamlessly with diverse teams and stakeholders. + Deep understanding of healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including ... preferred. + 10+ years of analytics & reporting experience in healthcare , including medical economics, cost/utilization analysis, and membership trend reporting. +… more
- University of Pennsylvania (Philadelphia, PA)
- …and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play. The University offers a competitive benefits package that ... includes excellent healthcare and tuition benefits for employees and their families,...observational studies, observational data, electronic health records, large administrative claims , and echo imaging databases. The incumbent will support… more
- Evolent (Trenton, NJ)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key ... of Actuaries credentials with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or… more