- 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)
- …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
- 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
- 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
- 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
- US Anesthesia Partners (New York, NY)
- …include proper record maintenance. + Assists in responding to unemployment claims and/or employment verifications as needed. + Facilitates and/or provides training ... sustain relationships. + Emerging Business Acumen: Eager to learn the healthcare industry, proactively seeks understanding of practice operations. + Critical… more