Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Clinical Policy & Claims Support Specialist

100 Horizon Healthcare Services, Inc

Horizon Blue Cross Blue Shield of New Jersey is seeking a Claims Analyst to review medical policies, prepare cases for clinical review, and track information requests to resolve clinical claims and service inquiries.

You will research member records, coordinate clinical reviews and appeals, and ensure accurate pricing and COB updates across all lines of business. Strong analytical, organizational, and communication skills are essential.

#J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Clinical Policy & Claims Support Specialist in Hopewell, NJ vacancy
  • $52.79k - $70.17k

     ...Responsible for reviewing medical policies, preparing cases for clinical review, and tracking additional information...  ...end to end resolution of clinical claims and service request/correspondence...  ...improves lives-while being supported by a missiondriven organization that... 
    Policy
    Live in
    Local area

    Horizon Blue Cross Blue Shield of New Jersey

    Hopewell, NJ
    3 days ago
  •  ...management sessions in the community as needed Required to attend mandatory training classes in accordance with Kintock training policies Perform other work related duties as assigned by the Director. Qualifications/Requirements: Four-year degree in a social,... 
    Policy
    Contract work
    Work experience placement
    Trial period
    Flexible hours

    The Kintock Group

    Ewing, NJ
    16 hours ago
  • $32.5 - $36 per hour

     ...empowering customers to achieve positive financial outcomes while supporting Intuit’s mission of “Powering Prosperity Around the World.”...  ...and resources for your community in accordance with Intuit’s policies \n Bilingual (English/Spanish) communication skills are a plus... 
    Policy
    Local area

    Intuit

    Princeton, NJ
    21 days ago
  • We are hiring a Program Support Specialist for one of our clients in Hamilton, NJ . Job Description Under the supervision of Regulatory Officer...  .... Research applicable federal and State laws, regulations, policies, and procedures supporting the Fair Hearing process. Scan,... 
    Policy
    Temporary work
    Casual work
    Work at office

    Biogensys

    Trenton, NJ
    3 days ago
  •  ...TitleThe New Jersey Judiciary Office of Probation Services, Child Support Enforcement Unit, is seeking an individual with excellent...  ...for both AOC and Vicinage staff regarding complex child support policy and procedure, NJKiDS, and financial matters. Provide technical... 
    Policy
    Full time
    Work experience placement
    Internship
    Work at office
    Local area
    Immediate start
    Remote work
    Trial period
    Monday to Friday
    Flexible hours

    New Jersey Courts

    Trenton, NJ
    4 days ago
  • $116k - $145k

     ...Premise Health Care Regional Clinical ManagerPremise's mission is to help people get, stay...  ...quality program and is responsible for supporting and oversight of AAAHC standards across...  ...messages and ensures implementation of policies and procedures.Assists in the identification... 
    Policy
    Daily paid
    Full time
    Contract work
    Work experience placement
    Local area
    Monday to Friday

    Credenza Health

    Hopewell, NJ
    2 days ago
  • $58.24k - $76.96k

     ...PIP Claims Representative CURE Auto Insurance is a leading direct writer of auto insurance...  ...that claims are processed within company policies, procedures, regulatory requirements, and...  ...Fun, engaging in-office events that support our culture Starting Salary: $58,240 -... 
    Policy
    Full time
    Work at office
    Local area
    Remote work
    Work visa
    Flexible hours
    1 day per week

    CURE Auto Insurance (Citizens United Reciprocal Exchange)

    Princeton, NJ
    3 days ago
  • $72k - $141k

     ...liability insurance. CNA Financial Lines has an opening for a Complex Claims Consultant handling Employment Practice Liability, Private and...  ...strategy. This individual will be able to utilize claims policies and guidelines, review coverage, determine liability and damages... 
    Policy
    Full time
    Work experience placement
    Work at office
    Local area
    Remote work
    Shift work

    CNA Financial

    Princeton, NJ
    4 days ago
  •  ...Hospital seeks a Pharmacist to perform standard hospital pharmacy duties in alignment with Baptist Health policies. The role emphasizes safe dispensing, clinical pharmacotherapy, and collaboration across care teams. Requires a pharmacy degree and Alabama state licensure... 
    Policy

    Brookwood Medical Center

    Princeton, NJ
    3 days ago
  •  ...Specialist, Global Contract Support Contract Support responsibilities are to provide assistance to sales with data entry and administrative activities...  ...and legal rules Processes monthly renewals per policy and communication to Sales Team Reconcile Renewal Pricing... 
    Policy
    Contract work
    Work experience placement
    Casual work
    Flexible hours

    HireTalent

    Princeton, NJ
    3 days ago
  • $137k - $235.75k

     ...Associate Director, Clinical Sciences, Ophthalmology (Early Development)Johnson & Johnson...  ...clinical trial protocols and materials and supports the completion of clinical study reports...  ...to the terms of their respective policies and date of hire, employees are eligible... 
    Policy
    Work at office
    Local area
    Worldwide

    J&J Family of Companies

    Hopewell, NJ
    21 hours ago
  •  ...Program Director in managing day-to-day clinical operations of MRSS, overseeing staff and...  ...include supervising Family Intervention Specialists and Crisis Intervention Specialists, coordinating...  ..., and ensuring compliance with CSOC/MRSS contracts and agency policies. #J-18808-Ljbffr
    Policy

    Catholic Charities, Diocese of Trenton

    Ewing, NJ
    4 days ago
  •  ...and seeks a Registered Nurse Outpatient Clinic. The role will contribute to person-centered...  ..., care coordination and clinical support; maintain accurate documentation and escalate...  ...gaps promptly, and follow role-specific policies and professional scope. Participate in orientation... 
    Policy
    Part time

    Grace Community Care and Homes Inc.

    Trenton, NJ
    1 day ago
  • $66.56k - $85.28k

     ...Job Description BI Litigation Claims Specialist \n \n CURE Auto Insurance is a leading...  ...Investigate the validity of claims, evaluate policy coverage, and determine if any...  ...n Fun, engaging in-office events that support our culture \n \n \n \n \n \n Physical... 
    Policy
    Work at office
    Local area
    Remote work
    Work visa
    Flexible hours
    1 day per week

    CURE Auto Insurance (Citizens United Reciprocal Exchange)

    Princeton, NJ
    2 days ago
  • $50k - $60k

     ...Claims Correspondence Analyst The Claims Correspondence Analyst will serve as a first...  ...expect: Culture of innovation, teamwork, supportive colleagues and leaders willing to invest...  ...shared drive Ensure compliance and company policies, regulatory requirements and... 
    Policy
    Full time
    Work at office
    Remote work

    W. R. Berkley

    Trenton, NJ
    2 days ago
  •  ...Job Summary:The Surgical Clinical Assistant (SCA) provides assistance to the Physician and Physician's Assistant with daily administrative...  ..., compliance with schedule prep, voicemail, compliance with policies and procedures, decrease wait times.Responsibilities may include... 
    Policy
    Home office
    Monday to Friday

    Rothman Orthopaedics

    Hamilton, NJ
    4 days ago
  •  ...join our Workers’ Compensation team in two key roles: Senior Claim Examiner and Lead Claim Examiner . Both positions play a critical...  ...the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a... 
    Policy
    Flexible hours

    AmTrust Financial

    Princeton, NJ
    4 days ago
  • $30 - $40 per hour

     ...Addiction Treatment and Recovery department and seeks a Licensed Clinical Alcohol and Drug Counselor. The role will contribute to person-...  ..., communicate service gaps promptly, and follow role-specific policies and professional scope. Participate in orientation, competency... 
    Policy
    Hourly pay
    Part time

    Grace Community Care and Homes Inc.

    Hamilton, NJ
    2 days ago
  • $50k - $55k

     ...Workplaces in Financial Services & Insurance Claims Representative , Auto Job Description...  ...and correctly coded based on the policy. Develops and maintains action plans to...  ...assignments. Performs other duties as assigned. Supports the organization's quality program(s).... 
    Policy
    Full time
    Contract work
    Work at office
    Local area
    Flexible hours

    Sedgwick

    Trenton, NJ
    4 days ago
  • $56k

     ...focused and always one step ahead!The Reinsurance Accounting & Claims Handling Analyst is responsible for the timely and accurate recording...  ...guidance and in accordance with agreed upon best practices, policies and procedures, and/or service level agreements:Record client... 
    Policy
    Contract work
    Temporary work
    Work at office

    Munich Re

    Princeton, NJ
    5 days ago
  • $25.25 per hour

     ...Health Place, Hamilton, NJ 08619 Job Title: Clinical Care Technician Location: RWJUH Hamilton...  ...part of our collaborative nursing team, supporting Registered Nurses in providing hands-on...  ...and staff, adhering to facility policies Communicate effectively with patients, families... 
    Policy
    Hourly pay
    Daily paid
    Shift work
    Night shift

    RWJBarnabas Health

    Ewing, NJ
    16 hours ago
  •  ...Services is seeking a Director of Workers’ Compensation Claims to lead a growing team supporting Princeton claim operations. This leader will partner...  ...company objectives. Ensure adherence to all AmTrust policies, procedures, and controls. Provide consistent communication... 
    Policy
    Work at office
    Local area

    AmTrust Financial

    Princeton, NJ
    3 days ago
  •  ...a Back of House colleague, you will play an essential role in supporting store operations, maintaining inventory accuracy, and ensuring...  ...workers, and supervisors Read and understand employment policies and safety rules/procedures in English Be comfortable... 
    Policy
    Seasonal work
    10 hours per week
    Flexible hours
    Afternoon shift

    Macy's

    Hamilton Square, NJ
    1 day ago
  • $23 - $30 per hour

    Auto Claims Representative - First Notice of Loss CURE Auto Insurance is a leading direct...  ...Program. Review the coverages under the policy and determine what coverages are...  ...programs Fun, engaging in‑office events that support our culture Physical Actions/Environment... 
    Policy
    Hourly pay
    Work at office
    Local area
    Remote work
    Work visa
    Flexible hours
    1 day per week

    CURE Auto Insurance (Citizens United Reciprocal Exchange)

    Princeton, NJ
    4 days ago
  • $62.4k - $93.6k

    Sr Representative Claims - CH08BE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too... 
    Policy
    Temporary work
    Work at office
    Remote work
    Monday to Friday
    3 days per week

    The Hartford

    Trenton, NJ
    6 hours ago
  •  ...Greater New Jersey Behavioral Health LLC is seeking a Peer Support Specialist to join the Lawrence Township team. This full-time, on-site...  ...lived experience effectively, and work collaboratively with a clinical team to support individualized wellness goals. #J-18808-Ljbffr
    Full time

    Atlantic Health Strategies

    Lawrence, NJ
    22 hours ago
  • $26.73 - $42.64 per hour

     ...Clinical Dietician - EDU (Per Diem)Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients...  ...medical record on a timely basis, in accordance with Policies and Procedures. Maintains all standards of confidentiality. Interacts... 
    Policy
    Hourly pay
    Daily paid

    Pennsylvania Medicine

    Plainsboro, NJ
    4 days ago
  • $63.69k - $106.14k

     ...this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines....  ..., and individualized within established guidelines and policies o Reviews clinical documentation for compliance, provides staff... 
    Policy

    Pennsylvania Medicine

    Plainsboro, NJ
    3 days ago
  • $16 - $18 per hour

     ...Seasonal Client Support Associate We are looking for someone who thrives in a welcoming, customer service-oriented environment with excellent...  ...protected by applicable federal, state, or local laws. This policy applies to all terms and conditions of employment, including... 
    Policy
    Hourly pay
    Extra income
    Local area
    Flexible hours

    Jackson Hewitt

    Trenton, NJ
    18 hours ago
  • $138.4k - $212.1k

     ...to delivering exceptional underwriting, claims, and risk management expertise to our partners...  ...external partners. The Senior Claims Specialist role is designed for professionals who...  ...depth understanding of coverage issues, policy forms, contracts, regulatory... 
    Policy
    Temporary work
    Princeton, NJ
    13 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Policy & Claims Support Specialist. Be the first to apply!