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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..
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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..
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..
... 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 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..
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..
... 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,..
... patient and drug information and process prescriptions. If PTCB or ExCPT ... with state, federal, and company policy. Reviews and complies with the ... adheres to the Walgreen Co...
... leads facility wide projects, prepares claims files (med mal, auto, property ... general liability insurance), works with claims and legal counsel in case ... case management, assists in determining..
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 ..
... 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..
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 ..
... 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..
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 ..
... Improvementu003cbr /u003eu0026bull; Promotes and maintains professional and effective relationships and communications ... participates in reducing workersu0026rsquo; compensation claims u003cbr /u003eu0026bull; Adheres to standards ... and ancillary services. In the..
