Managed Care Jobs in New Jersey
of company policies and procedures pertaining to the Medicare and Managedcare reimbursement in the facility. This position reports to the Administrator of the facility and receives consultative assistance from the Regional Clinical Reimbursement Specialist...
pertaining to the Medicare and Managedcare reimbursement in the facility. This position reports to the Administrator of the facility and receives consultative assistance from the Regional Clinical Reimbursement Specialist. The Clinical Reimbursement...
files submitted by Credentialing Analysts to ensure compliance with National Committee for Quality Assurance (NCQA), The Joint Commission (TJC) accreditation and other regulatory standards, internal policies and procedures and managedcare plan...
in accordance with National Vision protocol.
Processes and understands managedcare plans while obtaining document information from the insurance company as needed.
Provides customers basic and accurate information.
Schedules and confirms appointments, follow...
and to assist with reimbursement of care and/or appeals.Certifies/denies all non-managedcare cases on a daily basis. Denied day cases will automatically be referred to the Physician Advisor.Participants in Interdisciplinary D/C Rounds to concurrently...
in accordance with National Vision protocol.
Processes and understands managedcare plans while obtaining document information from the insurance company as needed.
Provides customers basic and accurate information.
Schedules and confirms appointments, follow...
multiple system applications
- Prior utilization review experience from a NJ/NY Automobile, Workers Comp, or ManagedCare company is a plus.
About the Company
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion...
General knowledge of public health, managedcare, human services systems, and local and statewide political systems preferred.
Experience working with people representing diverse backgrounds preferred.
Required skills/abilities:
Knowledge...
in a management role.
Experience working in a large, multi-location medical practice or Management Service Organization (MSO) environment
Experience with Athena Practice management software
Experience in all phases of managedcare contracting process, including...
practice, ensures that physicians are appropriately credentialed for all managedcare plans, and that billing processes and procedures are in place to maximize professional revenue. Ensures that the appropriate number and level of support staff...
recredentialing) files submitted by Credentialing Analysts to ensure compliance with National Committee for Quality Assurance (NCQA), The Joint Commission (TJC) accreditation and other regulatory standards, internal policies and procedures and managedcare plan...
with or depend on ManagedCare.
Our doctors are either W-2 Employees or Partners. This is not a salaried position but rather a position based on productivity as is the case in private practice. We will share with the Physician a percentage of the fees collected...
and privileging process and reappointment process for all new medical staff and allied health professional applicants to ensure the highest quality patient care at Cooper University Health Care.
The Specialist will also be responsible for designated managedcare...
comprehensive, outcomes-driven care to those who need it most. We offer integrated managedcare products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Responsibilities...
in marketing initiatives to spread awareness about OSH and its services.
Acquire and retain key accounts, including but not limited to cooperation with insurance companies and managedcare organizations to develop provider contracts.
Oversee branch billing...