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Description The Medical Coding Auditor extracts clinical information from ... to patient records. The Medical Coding Auditor work assignments are varied ... of action. Responsibilities The Medical Coding Auditor confirms..
Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical ... - Outpatient & Surgical Specialty Coding Team-Remote in US in Portsmouth ... New Hampshire Description The Medical Coding Auditor..
... final outcome when discrepancies in coding interpretation are identified Provide support ... and monitoring of Humana's medical coding communication efforts to promote accurate ... documentation Recommend and review medical..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description Humana welcomes fresh graduates to join its Cloud Security team. In this role, you will be part of a high-performing team of professionals, building multi-cloud security controls to secure applications ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The Claims Educator is responsible for ensuring prompt and accurate provider claims processing of original claims, resubmissions, and overall adjudication of claims. The Claims Educator manages claims operations that involve ..
Description This role will help drive the transition of Humana IT to a DevSecOps organization. This transition impacts culture, tools, automation, and development practices. In this role you will be on ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Portsmouth New Hampshire Description Humana is looking for an experienced Healthcare Investigator to join its ..
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 ..
... The Manager, Risk Adjustment oversees coding educators and quality assurance audits ... The Manager, Risk Adjustment oversees coding accuracy and the risk adjustment ... team of up to 11..
Job Information Humana Senior Cloud Security Engineer (virtual remote) in Portsmouth New Hampshire Description Responsibilities Our Department of Defense Contract requires U.S. citizenship for this position The Remote Senior Cloud Security ..
... Interoperability, 2) serve as a coding expert to manage escalations or ... acumen, and industry-standard clinical / coding guidance to ensure physician and ... position provides supportive clinical and..
Job Information Humana Sr. DevOps Cloud Engineer in Portsmouth New Hampshire Description Do you thrive on working on leading edge technology such as AKS and Kubernetes? Do you embrace the DevOps ..
Genesis HealthCare is one of the leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how ..
Job Information Humana Associate Director, Provider Data Interoperability in Portsmouth New Hampshire Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance ..
Our reward package We're hiring for two Senior Windows Infrastructure Engineers based in Exeter HQ with hybrid remote working. As our Senior Windows Infrastructure Engineer, your total reward package is potentially ..
... background and industry-standard clinical / coding guidance to ensure physician and ... position provides supportive clinical and coding expertise across the teams in ... those functions Serve as a..
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 ..
