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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 Senior Claims Process & Policy Professional processes ... modifications to existing policies, and claims forms. The Senior Claims Process & Policy Professional work ... variable factors. Responsibilities 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 Medical Coding Auditor extracts clinical information from a ... coding guidelines. The Medical Coding Auditor work assignments are varied and ... guidelines/procedures. As a Medical Coding Auditor for..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Claims Review Representative 2 - Remote ... in Tampa Florida Description The Claims Review Representative 2 makes appropriate ... based on strong knowledge of claims procedures, contract..
... 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..
... identify, assess, monitor and document claims and encounter coding information as ... Assess adequacy of documentation of claims and query outpatient provider claims to obtain additional medical record .....
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Florida Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... are met. The Medical Coding Auditor work assignments are varied and ... action. Responsibilities The Medical..
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 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 ..
... 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..
Job Information Humana Pharmacy Desktop Auditor (Claims Professional 2) in Tampa Florida ... pharmacy claim review. The Pharmacy Claims Professional 2 work assignments are ... education and experience Prior pharmacy..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Tampa Florida ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... 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..
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..
... Risk Management Professional - Pharmacy claims in Tampa Florida 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 ..
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..
Description The Risk Management Lead - Home Health works as a partner with Home Solutions teams to evaluate and analyze business processes, potential issues, and strategic opportunities to minimize risk, ensure ..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Tampa Florida ... Florida Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
