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Description The Senior Market Development Professional provides support to assigned health ... submissions. The Senior Market Development Professional work assignments involve moderately complex ... The Clinical Senior Market Development Professional..
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Description The Senior Claims Research & Resolution Professional works with operational teams, vendors, ... members in the processing of claims. Strong analytical skills focusing on ... knowledge and experience with..
... The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the ... The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex ... The Senior Medical/Financial Risk Evaluation..
... 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 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 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..
... The Senior Fraud and Waste Professional conducts investigations of allegations of ... The Senior Fraud and Waste Professional work assignments involve moderately complex ... The Senior Fraud and Waste..
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 ..
Job Information Humana UM Medical Director - Conviva in Indianapolis Indiana Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description The Senior Market Development Professional provides support to assigned health ... support. The Senior Market Development Professional work assignments involve moderately complex ... Responsibilities The Senior Market Development Professional..
... The Senior Consumer Service Operations Professional is responsible for the daily ... The Senior Consumer Service Operations Professional work assignments involve moderately complex ... The Senior Consumer Service Operations..
... and delivering on initiatives and process capabilities that enable improved effectiveness, ... identify, advise, lead and facilitate process improvement opportunities. KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes .....
... 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..
... 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..
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..
... 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,..
... 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..
... experiences, accurate and timely provider claims submissions, and high-quality care delivery ... for provider relations and training, claims education, provider engagement and practice ... including provider relations and training,..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical ... the Autism Care Demonstration (ACD) policy, TRICARE Operations Manual (TOM) Chapter ... session notes to the provider's claims..
... 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..
... 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..
