As a Medical Insurance Billing Specialist, you play a vital role in ensuring the financial accuracy and efficiency of our cardiology billing operations. This role focuses on: Insurance claim management Denial resolution Tracking reimbursement patterns to ensure claims are process...

The manager will lead a team of adjusters handling first-party medical claims, focusing on coverage review, medical treatment analysis, and ensuring timely exposure transfer. This role involves training leaders and adjusters on New Jersey PIP best practices while driving performance and efficiency within claims operations.

The primary responsibility involves reviewing and editing home sleep apnea tests for accuracy and completeness according to American Academy of Sleep Medicine (AASM) standards, and supporting patients prescribed the WatchPAT Home Sleep Apnea test. Essential functions include patient contact for kit arrival, procedure explanation, patient education, identifying signal issues, and maintaining equipment.

The role involves performing utilization review for Long Term Care and Hospice services, including prospective, concurrent, and retrospective reviews. The coordinator will also provide independent review decisions for behavioral health services and act as a liaison among various stakeholders.