- Prime Therapeutics (Trenton, NJ)
- …fuels our passion and drives every decision we make. **Job Posting Title** Treasury Claims Analyst Senior - Remote **Job Description** The Senior Treasury Claim ... for providing guidance to the Accounting, Finance, Information Technology and Claims operation functions, as well as Pharmacy Networks and Government Programs.… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 for the Financial Recovery ... Team, is responsible for analysis of overpaid claims and makes appropriate determinations based on strong knowledge...work in Eastern Standard Time Zone + Position is Remote As part of our hiring process, we will… more
- BAYADA Home Health Care (Pennsauken, NJ)
- BAYADA Home Health Care is seeking a Healthcare Medical Collections Associate to join our **Home Health Reimbursement Services** team. Are you looking for an ... your career and learn the business? Then the Reimbursement Associate position might be right for you! **This is... position might be right for you! **This is REMOTE position** . Qualified candidates must be able to… more
- Takeda Pharmaceuticals (Trenton, NJ)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... 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
- Humana (Trenton, NJ)
- …experience compared to rate development funding and budget to generate insights into claims trends and funding issues + Development of revenue and claim budget ... impacts + Programming and modeling in SAS and Excel to incorporate state specific claims taxonomies and various other ad hoc requests **Use your skills to make an… more
- Intermountain Health (Trenton, NJ)
- …for the development and maintenance of analysis, forecasting, and reporting of claims experience and trends, both in aggregate and various components. 3. Analyzes ... and other liabilities, contingent settlements, incentive and risk-share payments, reinsurance claims and other third-party claims and liabilities, etc. 4.… more
- Merck (North Wales, PA)
- …Director/Senior Director in the Office of Promotion and Advertising Review (OPAR) The Associate Director is responsible for the review and approval of all US ... meetings to ensure support for anticipated promotional messages and claims (aligned with marketing strategy) in clinical trial design...or BS degree with an emphasis in science, health care or related fields. + Preferred: Master's, PhD or… more
- Humana (Trenton, NJ)
- …put health first** Business Intelligence Engineers on the Provider Intelligence and Claims Analytics (PICA) team solve complex business problems and issues using ... of action. About Our Team The Provider Intelligence and Claims Analytics (PICA) team is a blend of experts...business outcomes and decisions **Additional Information** This role is " remote /work at home" and can be based anywhere in… more
- Humana (Trenton, NJ)
- … care working experience + Experience working with medical, pharmacy, lab claims + Demonstrated familiarity with value based care and/or clinical concepts ... Clinical Analytics Team is seeking a Research Scientist 2 ( Remote ). Healthcare is rapidly changing, and our members are...and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Leverage a… more
- Humana (Trenton, NJ)
- …Science, finance, Statistics, Economics or related field + Experience working with Claims , Billing and Reconciliation or related healthcare data + Expertise in ... and Root Cause Analysis (RCA) experience **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this… more
- Evolent Health (Trenton, NJ)
- …role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievance. - **Required** ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...with other Client Service Leaders including our Client Service Associate Director and Director may also be available. **What… more
- Humana (Trenton, NJ)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director reviews cases of diverse ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products +...protect member PHI / HIPAA information This is a remote position reporting to Grievance and Appeals Director or… more