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Description The Pharmacy Claims Lead operationalizes and monitors Coordination ... Cultural Competency Enable personal & professional growth Develop analytics and reporting ... business Actively identifies and owns process improvements and..
... related issues which may include claims inquiries, enrollment issues, travel attestations, ... Manual (TRM), and the TRICARE Policy Manual (TPM). Assist with questions ... with qualifying ASD diagnoses. Provide..
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Description The Medical Coding Coordinator 2 extracts clinical information from a ... records. The Medical Coding Coordinator 2 performs varied activities and moderately ... Responsibilities The Medical Coding Coordinator 2..
Description The Nurse Auditor 2 will work on the clinical ... audit concepts. The Nurse Auditor 2 will perform clinical audit and ... and abuse. The Nurse Auditor 2 work..
... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior Behavioral Health..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
Description The Senior Health Information Management Professional work assignments involve moderately complex to complex issues to work with various teams to develop business requirements, track and monitor the success of the ..
... 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..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management ... errors. The Health Information Management Professional work assignments are varied and ... Responsibilities..
... is a dispute on adjudicated claims that contain a code editing ... well-being. We also provide excellent professional development & continued education. Required ... Certification (no apprentice) Minimum of..
... Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing ... reporting. The Consumer Service Operations Professional 2 evaluates metrics for early identification ... of..
... agencies through the established UHC process Execute, plan and coordinate resources ... provider network, premiums, member services, claims, explanation of benefits, processes and ... within 60 days of hire..
Job Information Humana Regional VP, Health Services (Mid-Atlantic Region) in Washington District Of Columbia Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional VP, ..
... well-being. We also provide excellent professional development & continued education. Required ... direct reports Prior health insurance claims experience Excellent PC skills (including ... or religious exemption consideration. This..
... The Senior Fraud and Waste Professional conducts investigations of allegations of ... The Senior Fraud and Waste Professional work assignments involve moderately complex ... Knowledge of healthcare payment methodologies,..
... systems, and by ensuring correct claims payment and appropriate diagnosis related ... well-being. We also provide excellent professional development & continued education. This ... work experience reading and interpreting..
Description The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management ... errors. The Health Information Management Professional 2 work assignments are varied and..
... agencies through the established UHC process Execute, plan and coordinate resources ... provider network, premiums, member services, claims, explanation of benefits, processes and ... days of hire Bilingual Spanish..
