- Evolent (Trenton, NJ)
- …Join a mission with a company behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- Wesley Enhanced Living (Philadelphia, PA)
- …as a Best Workplace in our industry! Hiring Immediately! The Registered Nurse Assessment Coordinator (RNAC) provides for the initial assessment and periodic ... Care Conference and implement and update resident Plan of Care. The Registered Nurse Assessment Coordinator (RNAC) would: + Ensure accuracy of all sections of… more
- NJM Insurance (Trenton, NJ)
- …(ODG and/or MCG). + Conduct second level review of PIP Post-Service/Payment Appeals to assess prior determination and new records, including treatment, Independent ... business process improvements. Required Skills & Experience: + Actively licensed registered Nurse in New Jersey and Connecticut, Delaware, Maryland, New York or… more
- Intermountain Health (Trenton, NJ)
- …requests and/or review of denials to ensure medical necessity, payer policies, appeals and reconsideration needs. Promotes the quality and cost effectiveness of ... prior authorization, pre-determination and/or dispute denials via retro authorization, appeals or reconsiderations related to no authorization denials + Perform… more
- Virtua Health (Mount Laurel, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... communication with management regarding billing and coding issues including documentation, denials/ appeals , etc.* Follows up on assigned insurances on a monthly… more
- Virtua Health (Voorhees, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... testing results coordination, as well as pre-certification/insurance status and appeals . Coordinates the administrative flow of the patient experience. Reports… more