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Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... variable factors. Responsibilities Job Title:..
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Description The Medical Coding Coordinator 3 extracts clinical ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM,..
... Director, Pharmacy Clinical Formulary and Medical Strategies requires a broad understanding ... execute on the formulary and medical drug strategies. Responsibilities The Director, ... Director, Pharmacy Clinical Formulary and..
... team with an Inpatient Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities Job Profile The..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
... CGX and faxing to Humana Medical Directors for approval or denial ... experience Excellent verbal and written communication skills Ability to demonstrate excellent ... demonstrate excellent verbal and written..
Job Information Humana Senior Accreditation Professional in Colorado Springs Colorado Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance ..
We are growing quickly and urgently hiring for multiple positions, with varying available shifts/days, for non-Medical Caregivers. Prioritization will be given to candidates possessing HHA/CNA/MA/MT certifications, though these are not required. ..
... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what ... this information confidently to other..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 ... verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are ... Where you Come In The..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
Job ID 21000I3SAvailable Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
... Evaluate the element of the medical record for diagnosis code selection ... Query providers to obtain additional medical record documentation or to clarify ... matrix environment of coding educators,..
... support the coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
... be included in the patient medical records and support the provider ... Job Title: Your Home Advantage Medical Director Location: Louisville, KY or ... Certified in an approved ABMS..
... the team with a Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
