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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 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 ..
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..
Job Information Humana Manager, Fraud and Waste-Remote US in Montpelier Vermont Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Vermont Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Vermont Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Montpelier Vermont ... Vermont Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
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..
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 ..
... 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 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 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..
POSITION SUMMARY:Working under the direction of the Director of Nursing or RN designee, the LPN Nurse Practice Educator functions as a practitioner, consultant, educator and facilitator for all nursing staff focusing ..
... when they happen. The Nurse Auditor 2 validates and interprets medical ... of par and non-par provider claims to determine payment accuracy. Makes ... process improvements. Reviews and audits..
Sign On Bonuses for RN's and LPN's! Full Time: $10,000 Part Time: $5,000 POSITION SUMMARY: The Clinical Reimbursement Coordinator (RN) manages the overall process and tracking of all Medicare/Medicaid case-mix documents ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... Risk Management Professional - Pharmacy claims in Montpelier Vermont Description The ... the compliance of the pharmacy claims processing vendor relationship Develop executive-level ... job as we are a..
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 ..
Job Information Humana Pharmacy Desktop Auditor (Claims Professional 2) in Montpelier Vermont ... pharmacy claim review. The Pharmacy Claims Professional 2 work assignments are ... education and experience Prior pharmacy..
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..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Montpelier Vermont ... Vermont Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
POSITION SUMMARY: Under the direction of The Resident Care Director, Charge Nurse, the Unit Administrative Assistant performs administrative support activities required for documenting and coordinating care from patient admission through discharge. ..
... 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..
