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... modifications and enhancements to the claims processing systems and KPI reports ... to provide timely and insightful claims data. Review referred losses to ... policy issues to General Counsel,..
... The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems ... The Senior Business Intelligence Engineer (Claims Strategy) describes the tools, technologies, ... identify and measure anomalies in..
Description The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..
Job Information Humana Pharmacy Claims Specialist, Remote in Montpelier Vermont ... Montpelier Vermont Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Montpelier Vermont Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Description The Network Operations Coordinator contributes to the provider experience by managing the accuracy of the provider data within the health plan networks. The Network Operations Coordinator 4 assumes ownership and ..
Description Assist local pharmacies with claims adjudication to support medication access ... the direction of the Pharmacy Claims Team Leaders & the Pharmacy ... Team Leaders & the Pharmacy Claims..
Job Information Humana Fraud and Waste Investigator-Remote in US in Montpelier Vermont Description The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and ..
Job Information Humana Manager, Fraud and Waste-Remote US in Montpelier Vermont Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Job Information Humana Senior Informaticist - Remote or Office in Montpelier Vermont Description The Physician Performance Insights team's mission is to empower Humana members to make informed healthcare decisions. Our key ..
Description The Correspondence Representative 2 performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. Updates, maintains, and reviews fee scheduling and pricing ..
Description The Physician Performance Insights team's mission is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain high quality ..
Job Information Humana Senior Financial Analyst - Remote Nationwide in Montpelier Vermont Description The Senior Financial Analyst for Humana's Direct Contracting Entity, Humana Care Solutions, supports successful value-based provider relationships with ..
Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Montpelier Vermont Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, guidance, ..
Job Information Humana Medical Coding Coordinator 3- Remote USA in Montpelier Vermont Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Description The Bilingual Claims Research and Resolution Representative 2 ... you Come In The Bilingual Claims Research & Resolution Representative 2 ... services in the settlement of claims. Comprised of..
Job Information Humana Informaticist - Remote in Montpelier Vermont Description The Informaticist coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
... The Senior Business Intelligence Analyst (Claims Strategy) solves complex business problems ... The Senior Business Intelligence Analyst (Claims Strategy) describes the tools, technologies, ... identify and measure anomalies in..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Montpelier Vermont Description The Fraud and Waste Professional 2 conducts investigations of allegations of ..
... Medical Coding Auditor reviews medical claims submitted against medical records provided, ... systems, and by ensuring correct claims payment and appropriate CPT/ HCPCS ... Medical Coding Auditor reviews medical..