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Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..
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Description The Senior Business Intelligence Analyst (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Analyst ..
Job Information Humana Provider Reimbursement Professional 2-Remote in US in Springfield Ohio Description The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk. ..
... requirements. Identify criteria needed for Claims Processing configurations rules to ensure ... Processing configurations rules to ensure Claims system is consistent with CarePlus ... system is consistent with CarePlus..
Job Information Humana Senior Provider Engagement Professional in Springfield Ohio Description Humana Healthy Horizons Plan in Ohio seeks highly motivated Engagement Professionals to provide end to end provider experience as a ..
Description The Provider Engagement Professional 2 in Ohio develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within ..
Description Responsibilities This role may be completely remote from anywhere in the US, or onsite/hybrid from Louisville, KY. The Associate Actuary, Valuation is responsible for estimates of reserves required for unpaid ..
Description The Claims Research & Resolution Professional 2 ... & Resolution Professional 2 manages claims operations that involve customer contact, ... contact, investigation, and settlement of claims for and against..
Description The Medical Coding Auditor 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 Coding ..
Description The Business Systems Analysis Professional 2 performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. The Business Systems Analysis ..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Job Information Humana Associate Director, Provider Data Interoperability in Springfield Ohio Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and ..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Description The HPS Release Management Engineer 2 manages cross-organizational efforts required to introduce applications and infrastructure changes into the production environment. The Release Management Engineer 2 work assignments are varied and ..
Description The Senior Software Engineer codes software applications based on business requirements. The Senior Software Engineer work assignments involve moderately complex to complex issues where the analysis of situations or data ..
Job OverviewA law firm seeks a seasoned, results-driven Attorney to join its personal injury practice in Dayton, OH. The ideal candidate will manage a large docket of personal injury cases across ..
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 Claims Educator is responsible for ensuring ... ensuring prompt and accurate provider claims processing of original claims, resubmissions, and overall adjudication of ... resubmissions, and overall adjudication of..
Description Claims Research & Resolution Representative 2 ... Where you Come In The Claims Research & Resolution Representative 2 ... services in the settlement of claims. Comprised of a group..
Job Information Humana Claims Review Representative 2 in Springfield ... in Springfield Ohio Description The Claims Review Representative 2 , will ... based on strong knowledge of claims procedures, contract..
