Credentialing Specialist PRISM Vision Group Essential Function and Responsibilities Add, update and maintain accurate provider information in CAQH, CredentialStream and other tools commonly utilized for credentialing and payer enrollment. Work closely with providers, internal departments and other team members to obtain necessary information for timely onboarding. Complete, submit, document and pro-actively track and follow-up on required credentialing, enrollment and re-credentialing applications, paying close attention to details. Gather, compile and continuously monitor information necessary for enrollment and credentialing purposes. Update and inform department and other leadership of progress and issues using various means of communication. Research and respond to internal and external inquiries related to enrollment and credentialing issues. Maintain working knowledge of applicable regulations, policies and procedures and understand specific application requirements for both facilities credentialing applications and payer enrollment submission. Work collaboratively in a team environment to achieve team and organizational goals by sharing information and resources. May assist other team members with the provider licensing and renewal process. Maintain a high level of confidentiality regarding legal matters, privacy issues and data integrity. Miscellaneous job-related duties as assigned. Essential Qualifications Education: Bachelor's degree Experience: 3-5 years of experience in a medical service profession, payer enrollment, insurance plan, revenue cycle, or a combination. Knowledge/Skills/Experience Must be accountable, organized and work independently to self-manage assignments. Knowledge and understanding of the credentialing process; ability to apply principles, procedures, requirements, regulations and policies. Effective communication and interpersonal skills for collaboration with internal teams and external stakeholders Familiarity with CAQH, Availity, PECOS, NPPES and other common credentialing and payer enrollment tools Thrive in a fast-paced, dynamic organization with the ability to work with and prioritize multiple assignments and deadlines while adapting to change as priorities shift. Express thoughts and information clearly, concisely and effectively both verbally and in writing Critical thinker, anticipating next steps. CPCS certified a plus Experience with CredentialStream preferred. Computer Proficiency, Microsoft Office to include Word, Excel, Power Point. PRISM Vision Group is an Equal Opportunity / Affirmative Action employer. Candidates are selected solely on the basis of legally permissible job-related criteria without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.%16911601% %%admin%% New Providence, NJ, US, 07974Posted an hour ago Medical Billing Specialist. 21 Plus, Inc. 21 Plus is looking for a Medical Billing Specialist, who is responsible for processing Medicaid billing, claims, and service documentation . The position will be located in Manchester, NJ. *Medical Billing Specialist Duties:* * Oversees and monitors all aspects of Medicaid eligibility and billing. * Confirms consumer Medicaid eligibility in NJMMIS Portal. * Reviews and obtains SDRs and Prior Authorizations service documentation all consumers. * Updates Rates and Client Tier information in the Netsmart System as needed. * Prepares/submits Medicaid claims electronically using Netsmart system and the HIPPA NJMMIS portal. * Prints Medicaid billing report, save to drive and prepare excel Templates for recording of Medicaid billing into Sage Accounting Software. * Follows-up on all claims from billing through final resolution, maintain accurate and current Accounts Receivable. * Downloads Remittance advices and 999s for entry into Netsmart and recording of the payrment in Sage Accounting Software. * Posts payments in Netsmart via 999 upload * Reviews and follows up on remittance advice for payment errors, denials and under/over payments. * Interprets EOB and collections reports accurately. * Generates reports regarding revenue, pending claims, dates of payment, etc. * Facilitates billing operations by following policies and procedures; HIPAA compliance and reporting compliance issues. * Prepares, sends and records all financial transactions related to billing and receipt of payments for all clients rent and contribution to care fees. * Prepares and coordinates all financial transaction related to the Supportive Housing Corporation (SHC) rental assistance program grant. * Coordinates and assembles documentation, with assistance from Residential Services, of the consumers Social Security and Medicaid renewal submissions to Social Security and Medicaid. * Prepares and submits monthly Medicaid Attendance Projection, Medicaid Actual vs. Projection, Placement & Vacancy and Residential Billing Attendance reports to the Finance Director. * Prepares, reviews and submits client Trust applications. Maintain all Trust files including but not limited to deposits, withdrawals, receipts and monthly Trust statements. Work collaboratively with Trust Administrator, Guardians, SPA’s and Directors to assure all documents are received and processed in a timely manner. * Reviews all monthly client PNA reports received from SPA’s for accuracy, receipts and proper documents to ensure client funds are being tracked and accounted for. Notify the Finance Director and Director of Residential Services of any issues that are discovered, questions or corrections that may be required. * Prepares and submits the annual Social Security Rep Payee for all consumers to the Finance Director for review and approval. * Assists, when time allows, in preparing the monthly Rep Payee Bank Reconciliations. * Works collaboratively with the finance team members and assist with other projects as necessary. * Cooperates with the licensee and the Department of Human Services staff in all investigations and inspections. * Adheres to the organization’s financial policies and procedures. *Qualifications:* * 3-5 years medical billing experience required (experience billing with an Electronic Health Record System required) * Medical billing experience and familiarity with SSI /SSA renewal packages preferred. * Intermediate to advanced knowledge of MS Office and Excel. * Associates Degree preferred. * Full knowledge of accounts receivable, accounting excel spreadsheets and general accounting practices. * Must be at least 18 years old, have a valid NJ Driver’s License with an acceptable record of safe driving * High School Diploma / GED (verifiable) *PLUS* * Excellent time management skills. * Strong organizational skills. * Clear verbal and written communication skills. * Ability to multi-task and meet deadlines. * Sound judgment and decision making skills. Job Type: Full-time Benefits: * Dental insurance * Employee assistance program * Health insurance * Life insurance * Paid time off * Vision insurance Schedule: * Monday to Friday Education: * High school or equivalent (Required) Experience: * Medical billing: 3 years (Required) Ability to Commute: * Manchester, NJ 08759 (Required) Work Location: In person %13972809% %%medinfo%% Manchester, NJ, US, 08759Posted an hour ago Registered Nurse (RN) ICU. INFOSAGE SYSTEMS We are seeking a highly skilled and compassionate Registered Nurse to join our ICU team. As an ICU Nurse, you will provide critical care to patients with life-threatening conditions in a fast-paced and dynamic environment. Your expertise and dedication will make a significant impact on the lives of our patients and their families. Bronx, NY, US, 10457Posted an hour ago MLTC Intake Nurse - RN. RCM Health Care Services The role of the Intake RN will be responsible for knowing require outreach activities within the community and the assessment of eligibility and safety of potential members. Collaborate with other members of the Intake/Outreach team and the clinical team to assure the appropriate provision of services to new members. Communicate with potential members, family, referral sources and physicians to assure a seamless transition to managed long term care. Brooklyn, NY, USPosted an hour ago Revenue Cycle Director (Outpatient Billing) Atlas Search LLC The Revenue Cycle Director is responsible for the strategic direction and operational management of the revenue cycle function, with a specific emphasis on outpatient billing operations. The Director will lead a team of billing professionals to ensure accurate, timely, and compliant billing practices that maximize revenue capture and optimize cash flow. Ridgewood, NJ, USPosted an hour ago Outside Account Manager. State Industrial Products Since 1911, State Industrial Products has helped customers "Care for Work Environments"®. Throughout the years, our main focus has been to help customers enhance building environments and improve equipment productivity. No matter where you go in the United States, Canada or Puerto Rico, you will find State products hard at work in every industry imaginable. From market leading drain maintenance and air care programs to innovative cleaning systems, maintenance supplies and auxiliary programs, State Industrial Products offers facility management benefits that are second to none. We’re a thriving company, and we’re looking for driven individuals to join our team. That’s where you come in! Union, NJ, USPosted an hour ago RN Supervisor. The Phoenix Rehabilitation and Nursing Center Tired of the same old nursing home routine? We are taking a very fresh approach to skilled nursing. We offer frequent employee recognition meals, opportunities for all expense paid resort vacations, advancement opportunity, and free uniforms. Come in for an interview with our Administrator and DON and receive a gift card for gas!! Brooklyn, NY, US, 11201Posted an hour ago Hospice Registered Nurse Case Manager (RN) Suncrest Hospice At Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients. This is achieved by allocating the resources to increase our staff to patient ratios, thereby increasing clinical visits while lowering clinician caseloads. We are proud to be a Community Health Accreditation Partner (CHAP) certified hospice. If you have a commitment to providing the highest quality of care to patients and their families, we would like to hear from you! Marlton, NJ, US, 08053Posted an hour ago Women's Health Nurse Practitioner. GreenLife Healthcare Staffing Greenlife Healthcare Staffing is currently seeking a Women's Health Nurse Practitioner to fill an opening with a Family Health Center located in Far Rockaway, Queens, New York *Requirements of the Women's Health Nurse Practitioner:* * Must have an active NY State License * Must be Board Certified * Experience is preferred * Bilingual in Spanish is preferred *Benefits of the Women's Health Nurse Practitioner:* * The salary for this position is $160,000 - $170,000 / yr (based on experience) * This is a Full-time position * Full benefits package * Student loan repayment * Opportunity to work with an underserved population * Sense of community among staff * Work-life balance * Great work environment *Responsibilities of the Women's Health Nurse Practitioner:* * Educate patients about women's health issues. * Perform annual exams and provide well-woman care. * Help women with family planning and selecting birth control. * Offer care during perimenopause and menopause. * Diagnose and help patients manage sexually transmitted diseases. * Provide care for acute or chronic medical conditions. _Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices._ _If you would like to learn more about other opportunities we offer, please call our office: or submit your Resume/CV to #IND1 Job Type: Full-time Pay: $160,000.00 - $170,000.00 per year Benefits: * Dental insurance * Health insurance * Vision insurance Medical specialties: * Internal Medicine * Labor & Delivery * Primary Care * Urgent Care Standard shift: * Day shift Weekly schedule: * Monday to Friday Work setting: * Clinic * In-person * Private practice Work Location: In person %7303296% %%mednurse%% Queens, NY, USPosted an hour ago Sales. MLM Home Improvement We are looking for energetic, hard working sales people who are always looking to excel and expand their opportunities. Self-motivated individuals with a passion to connect with people and generate interest in our products and services. Bridgewater, NJ, US, 08807Posted an hour ago