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... contract is responsible for processing claims for more than 6 million ... than 6 million members, the claims processing and financial management functions ... to an external vendor. The..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... when they happen. The Nurse Auditor 2 validates..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description Humana's Provider Payment Integrity organization is looking for a Senior Vendor Management Professional to join the Data Mining Vendor Management team! As the Senior Vendor Management Professional you will act ..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding Auditor work assignments are varied and ... for an experienced medical coding auditor to..
... 5 or more years of healthcare revenue cycle management experience may ... for Medicare and Medicaid related claims) Experience with Auditing and monitoring ... with Auditing and monitoring of..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... that our members receive quality healthcare at an affordable..
Description The Nurse Auditor 2 will work on the ... lab audit concepts. The Nurse Auditor 2 will perform clinical audit ... waste, and abuse. The Nurse Auditor 2 work..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Arizona Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Phoenix Arizona ... Arizona Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Arizona Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Phoenix Arizona ... Arizona Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Pharmacy Desktop Auditor (Claims Professional 2) in Phoenix Arizona ... pharmacy claim review. The Pharmacy Claims Professional 2 work assignments are ... education and experience Prior pharmacy..
... Risk Management Professional - Pharmacy claims in Phoenix Arizona Description The ... the compliance of the pharmacy claims processing vendor relationship Develop executive-level ... job as we are a..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Job Information Humana Manager, Fraud and Waste-Remote US in Phoenix Arizona Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Job Description As the Medicare Pharmacy Audit Programs Project Manager you will be responsible for administering Medicare Part D Pharmacy Audit programs. In this role, you will be expected to familiarize ..
... mind and spirit. The Pharmacy Claims Reviewer is responsible for reviewing ... is responsible for reviewing pharmacy claims submitted through the CVS Health ... submitted through the CVS Health..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
OverviewThe primary purpose of the position is the management and administration of all aspects of rehabilitation services for the respective communities as well as for maintaining a clinical caseload.The Rehabilitation Program ..
