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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..
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 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 ..
... 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 Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... to day work of reviewing claims payments for clinical/coding..
... 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 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..
... systems, and by ensuring correct claims payment and appropriate CPT/ HCPCS ... well-being. We also provide excellent professional development & continued education. This ... work experience reading and interpreting..
... 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 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..
Job Information Humana UM Medical Director - Conviva in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
... 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..
