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Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
... systems with corrections to provider records and verify updates are complete. ... internal correspondence control numbers. Request medical records. Print and prepare audit folders. ... tracking system. 15% Research..
... for performing clinical audits on medical record documentation for quality and ... support the submitted charges. Comprehensive medical records review will be conducted on ... other duties as assigned..
... 2 includes data entry into medical management system, assigning an appropriate ... provider, reviewing for benefits, and/or medical necessity as required or pending ... pending to a nurse or..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
... and documents in the patient medical record, adjusts or modifies the ... approved algorithm(s), and documents appropriate medical justification and effectiveness. Ensures correct ... entered and acknowledged in the..
... under the direction of the Supervisor and with guidance from the ... and documents in the patient medical record makes adjustments or modifications ... notifies Team Leader Charge Nurse..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Ridgeland Mississippi Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
... Business Support Coordinator 1 performs medical record content analysis to ensure ... stage for final distribution all medical records received into the Medical Record Review Department. Analyze content .....
... condition directly to the nurse supervisor. Observe patient, and conduct machine ... unusual findings to the nurse supervisor. Perform and document any intervention ... unusual findings to the nurse..
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 ..
