NJM Insurance Group
1001 - 5000 employees
Founded 1913
Insurance
NJM Insurance Group is a well-established insurance provider offering a range of personal and commercial insurance products. Their services include auto, homeowners, renters, condo, commercial auto, and business insurance, with a focus on exceptional customer satisfaction and claims experience. NJM is recognized for its outstanding auto claims experience by J. D. Power and is committed to serving customers in states like Connecticut, Maryland, New Jersey, Ohio, and Pennsylvania. The company prides itself on being straightforward and customer-focused, without jingles or mascots, offering trusted insurance solutions and multiple discount opportunities for various policies.
Managed Care Coordinator
Job not on LinkedIn
🔥 4 hours ago
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NJM Insurance Group
1001 - 5000 employees
Founded 1913
Insurance
NJM Insurance Group is a well-established insurance provider offering a range of personal and commercial insurance products. Their services include auto, homeowners, renters, condo, commercial auto, and business insurance, with a focus on exceptional customer satisfaction and claims experience. NJM is recognized for its outstanding auto claims experience by J. D. Power and is committed to serving customers in states like Connecticut, Maryland, New Jersey, Ohio, and Pennsylvania. The company prides itself on being straightforward and customer-focused, without jingles or mascots, offering trusted insurance solutions and multiple discount opportunities for various policies.
📋 Description
• Performs review of service requests for completeness of information • Collection and transfer of non-clinical data • Acquisition of structured clinical data from physicians/patients • Prepare, document and route cases in appropriate system for clinical review • Initiates call backs and correspondence to members and providers to coordinate and clarify benefits • Reviewing professional medical/claim policy related issues or claims in pending status • Acts as liaison with providers, members and Care Managers • Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence • Assists members with finding providers, resolving problems and answering questions • Makes outbound calls to engage members in Case Management and complete health assessments • Educates members regarding preventive health activities and services • Assists members to make appointments with their PCP, specialists, and/or transportation • Review medical, dental and vision claims and address gaps in member's preventative care
🎯 Requirements
• High School Diploma/GED required • Prefer 1-2 years customer service or medical support related position • Requires knowledge of medical terminology • Requires Good Oral and Written Communication skills • Requires ability to make sound decisions under the direction of Supervisor • Prefer knowledge of contracts, enrollment, billing & claims coding/processing • Prefer knowledge Managed Care principles • Prefer the ability to analyze and resolve problems with minimal supervision • Prefer the ability to use a personal computer and applicable software and systems • Team Player, Strong Analytical, Interpersonal Skills
🏖️ Benefits
• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement
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