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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..
Job Information Humana Compliance (UM) Coordinator 2 in Ridgeland ... in Ridgeland Mississippi Description The Compliance (UM) Coordinator 2 conducts and ... Coordinator 2 conducts and summarizes compliance audits. The..
... 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 Senior Compliance Professional ensures compliance with governmental requirements, specifically risk ... governmental requirements, specifically risk adjustment coding and medical record document requirements. ... clinics including serving as a..
Job Information Humana Associate Director, Provider Data Interoperability in Ridgeland Mississippi Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and ..
... 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..
... 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..
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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 ..
... to patient records. The Medical Coding Auditor work assignments are varied ... the United States. Provides expert coding auditing, coding and documentation improvement education. Performs ... reviews Utilizes encoders..
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 ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical ... - Outpatient & Surgical Specialty Coding Team-Remote in US in Ridgeland ... Ridgeland Mississippi Description The Medical Coding Auditor..
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 ..
Description The Plan Build Representative 2 loads data from tables into multiple platforms which can include rates, CPT codes, etc. Implements provider demographic updates to remain compliant. Testing and implementation of ..
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 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 Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Ridgeland Mississippi Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana Sr. DevOps Cloud Engineer in Ridgeland Mississippi Description Do you thrive on working on leading edge technology such as AKS and Kubernetes? Do you embrace the DevOps workstyle ..
... 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 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 ..