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Description The Medical Coding Coordinator 3 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 The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
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 ..
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 ..
Job Information Humana Senior Fraud & Waste Investigator - Remote in Bridgeport Connecticut Description Are you looking to be a part of a Fortune 100 company with competitive salary, opportunity for ..
Job ID 21000ESTAvailable 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 Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position ..
Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, ..
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 ..
... field preferred but not essential. Certified Coding Specialist-Physician based (CCS-P) through ... Information Management Association (AHIMA) or Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H) through American Academy..
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 ..
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 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 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 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 ..
