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Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Associate Director, Quality Assurance for Humana/Your Home Advantage (YHA) develops and implements programs to establish and maintain quality standards of existing products and services pertaining to In Home Wellness ..
Job Information Humana Medical Coding Coordinator 3- Remote USA in Brentwood Tennessee Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Brentwood Tennessee Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a ..
Description The Senior Compliance Professional ensures compliance with governmental requirements, specifically risk adjustment coding and medical record document requirements. This role acts as the second line of defense by providing oversight ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Job Information Humana Physician - CenterWell - Atlanta, GA in Brentwood Tennessee Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
Description The Senior Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Senior Coding Educator work assignments involve moderately complex to ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Job ID 21000LNVAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
