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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 ... of variable factors. Responsibilities The..
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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 Representative 3 works with regional provider offices to ensure timely submission of requested medical records that are submitted to the Centers for Medicare and Medicaid Services (CMS) ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Portsmouth New Hampshire Description Humana is looking for an experienced Healthcare Investigator to join its ..
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 ..
... 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..
Description The Medical Director actively uses their medical background, experience, and judgement to ... and other sources of expertise. Medical Directors will learn Medicare and ... in their daily work...
... at home and receive the medical care required. Registered Nurse (RN) ... and reliability. Benefits may include medical, dental, vision, and life insurance; ... year of recent, verifiable clinical..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours Responsibilities The..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities..
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 ..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... daily work. Responsibilities Job..
... Information Humana Manager, Pharmacy and Medical Trend in Portsmouth New Hampshire ... drug trends, both pharmacy and medical, as well as the impact ... Humana profitability. Responsibilities Lead our..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Portsmouth New Hampshire Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
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 ..
... Position Summary The HIM Coding Specialist will handle medical coding and data entry / ... based upon documentation in the medical record Correctly assign modifiers to ... contract and..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
Job Information Humana UM Medical Director - Conviva in Portsmouth ... Portsmouth New Hampshire Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours. Responsibilities The..
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 ..
