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Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
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 ..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on the ..
Description The Dr. Call Phones Pharmacy Technician works from home in a call center capacity and provides resolution for prescriptions that are considered incomplete, invalid, or contain clinical issues preventing the ..
Description The Senior Stars Improvement Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve quality performance within assigned geographic markets ..
Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
Description The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Clinical Services Pharmacy Technician takes calls from patients, pharmacies and providers, and performs varied activities and moderately complex administrative, operational, and customer support assignments. The Clinical Services Pharmacy Technician ..
Description The Inbound Contacts Representative 4 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..