Appeals jobs in Hackensack, New Jersey (NJ) State

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. Gathers and evaluates the information for appeals of Managed Care audits, clinical and technical denials by utilizing various Epic and legacy systems for Hackensack Meridian ...

Prioritize and organizes all prior authorization activities Documents all prior authorization activities and record activity Excellent communication and organizational skills with a customer service focus Ability to read and understand EOB’s and ERA files Processing appeals Analyze and researc......

This position is a dynamic role requiring the evaluation of disability claim appeals. In addition to managing a caseload of complex appeals, this position may offer the opportunity to identify trends to optimize the performance of the organization including providing feedback, initiating continuo...

As a DRG Downgrade Appeals Clinician, you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor. You will perform retrospective clinical case reviews and draft appeals that focus on estab...

Direct daily work on part C appeals (both provider and member/nonparticipating providers) and Part D appeals. Responsibilities of this Medical Director role are related to Medicare Appeals. Provide after hours and weekend coverage on a rotational basis to support 24/7 appeals work. Provide ongoin...

Licensed as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) in the State of Florida. The Registered Nurse independently plans, implements, and evaluates nursing care in patient care situations using standards of care, policy, and procedure. ...

Licensed as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) in the State of Florida. The Registered Nurse independently plans, implements, and evaluates nursing care in patient care situations using standards of care, policy, and procedure. ...

Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24/7 support, and a responsive, traveler-first culture.What are you waiting for? Apply today!.Valid license and/or certification in state of practice, if applicable .Demonstrated ability to maintain hig...

TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Morristown, New Jersey, 07962!. A diverse range of assignments on your resume showcases your adaptability, versatility, and resilience. ...

Our Client is currently seeking Med Surg for positions in Neptune, NJ for a 3x12 Nights shift.The ideal candidate will possess a current NJ license or Compact license Depending on the state.You must have a License and at least 1 years of recent experience as a Med Surg.South or North of this rang...

ARMStaffing is looking for RN - Case Management in Morristown, New Jersey. ...

VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Union City, New Jersey. Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review, including the design, testing and evaluation of the review m...

Travel Nursing: Cath Lab Camden.Location:         Camden.Start Date:       7/8/2024.Shift Details:   10H Days (8:00 AM-6:00 PM).Length:            13 WEEKS 13 weeks.Apply for specific facility details....

TravelNurseSource is working with Stability Healthcare to find a qualified Case Manager RN in Morristown, New Jersey, 07960!. Case management hospital experience. Minimum of 2 years of experience as an RN. ...

Ready to learn more? Apply today to start your Travel Adventure with LRS Healthcare!. ...

TravelNurseSource is working with Host Healthcare to find a qualified Labor/Delivery RN in Edison, New Jersey, 08820!. Travel nurses can bring fresh perspectives to healthcare facilities, contributing ideas and insights that may lead to improvements in patient care, safety, and overall healthcare...

Host Healthcare is an award-winning travel healthcare company with an immediate opening for this .Passionate and transparent team members have made Host Healthcare the agency of choice for new and experienced travelers looking for opportunities far away and close to home.Starting the day you appl...

VNS Health is seeking a Registered Nurse (RN) Home Health for a nursing job in Ridgefield, New Jersey. Current license to practice as a Registered Nurse in New York State  . Our nurses provide the Future of Care by meeting patients where they are. Be part of our 130-year history and innovative Fu...

At ARMStaffing we take care of our nurses! We offer:. ...

Host Healthcare is an award-winning travel healthcare company with an immediate opening for this .Passionate and transparent team members have made Host Healthcare the agency of choice for new and experienced travelers looking for opportunities far away and close to home.Starting the day you appl...

Our Client is currently seeking Med Surg for positions in Somers Point, NJ for a Nights shift.The ideal candidate will possess a current NJ license or Compact license Depending on the state.You must have a License and at least 1 years of recent experience as a Med Surg.South or North of this rang...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Edgewater, New Jersey. Coordinates external case reviews requested by enrollees, including preparing and submitting documentation according to regulatory requirements and tracking external reviews through...

Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24/7 support, and a responsive, traveler-first culture.What are you waiting for? Apply today!.Valid license and/or certification in state of practice, if applicable .Demonstrated ability to maintain hig...

TravelNurseSource is working with Host Healthcare to find a qualified OR RN in Jersey City, New Jersey, 07302!. Travel nurses often play crucial roles in responding to healthcare crises or natural disasters. ...