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... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what each ... it should represented in..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Charleston West Virginia Description Humana is looking for an experienced Healthcare Investigator to join its ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Charleston West Virginia Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..
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..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
... team of 20-25 nurses and medical professionals that performs the following ... that performs the following functions: medical necessity/level of care reviews, provider ... education on the utilization and..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
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 ..
Job Information Humana Senior Contract Tools, Education, Processes Professional - Remote in Charleston West Virginia Description The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, case ..
... Certified Diabetes Care and Education Specialist-Remote-US in Charleston West Virginia Description ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... in reviewing actual and proposed medical care and services against established ... against established CMS and Humana..
