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Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Kansas City Missouri Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Overland Park Kansas Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Kansas City Kansas Description The Fraud and Waste Professional 2 conducts investigations of allegations ..
... 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 The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Kindred at Home Accounts Receivable Specialist Home Health Full Time in Overland Park Kansas As an Accounts Receivable Specialist , you will: Ensure the coordination of claim activities and ..
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 The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding ..
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 The UM Compliance Letters Specialist/Coordinator 2 contributes to administration of utilization management in the Compliance department. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. ..
Job Information Humana Pharmacy Claims Specialist, Remote in Overland Park Kansas Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 ..
Job Information Humana Senior Integration Specialist - Cloud in Overland Park Kansas Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between ..
Job Information Centerwell Revenue Specialist Home Health in Overland Park Kansas As a Revenue Specialist , you will: Daily audit of admission, discharge and other source documentation to ensure revenue is ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
... 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 Kindred at Home Medicare Accounts Receivable Specialist in Overland Park Kansas As an Accounts Receivable Specialist , you will: Ensure the coordination of claim activities and designated agencies, and ..
... Associate Agreement when necessary. Coordinate payment runs for multiple payment types and resolution of outstanding ... and project invoices and coordinate payment. Calculate monthly expense accruals. Deliver ... raise..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Kindred at Home Healthcare Claims Denials and Appeals Specialist ... to obtain zero balances. Clear payment variances, resolving differences, and initiating ... claims processing experience Knowledge of healthcare..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
... Qualifications Minimum 5 years of healthcare fraud investigations and/or auditing experience ... of Florida and Wisconsin Medicaid healthcare payment methodologies Strong organizational, interpersonal, and ... the required qualifications. Understanding..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
