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... 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..
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..
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..
... 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..
... implemented, incorporation of enhancements, or process improvements. Job Requirement Education/Experience: Equivalent ... following areas: access, revenue, billing, claims applications, combined with advanced computer ... training and education; independently performing..
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..
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..
... 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 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 ..
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..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
... 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..
... department. Required Qualifications CPC (Certified Professional Coder) Certification or equivalent required ... Advanced knowledge of billing / claims submission and other related functions ... time According to Humana's COVID-19..
... 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,..
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 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..
Job Description This is a full-time telework role. Working schedule: Monday-Friday, 8am-5pm (Pacific Time) Help us elevate our patient care to a whole new level! Join our Aetna team as an ..
... 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..
... 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..
