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Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Job ID 21000BICAvailable Openings 1Position Specific Information This role requires floating throughout the state to cover as Clinical Manager as needed. PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and ..
Job ID 21000KQ1Available Openings 1 PURPOSE AND SCOPE: Ensure the provision of quality patient care to all hospitalized patients in the most efficient manner in accordance with company policy. Provides direct ..
Job Information Humana Manager, Fraud and Waste-Remote US in Saint Paul Minnesota Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... provider records ensuring appropriateness of billing practices. Prepares complex investigative and ... Qualifications Bachelor's degree or significant..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Minneapolis Minnesota Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
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. Responsibilities ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
Save job Refer friends Job description Commute time Pharmacy Technician / Pharm Tech Apprenticeship Title Pharmacy Technician / Pharm Tech Apprenticeship Job Description Our pharmacy technician positions have undergone an exciting ..
Job Information Centerwell RN Clinical Manager Home Health Full Time in Edina Minnesota The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, ..
... is looking for an experienced Healthcare Investigator to join its industry ... provider records ensuring appropriateness of billing practices. Prepares investigative and audit ... areas Bachelor's degree or significant..
Job Information Humana Senior Counsel - Home Health in Minneapolis Minnesota Description The Senior Counsel - Home Health position is for an attorney who will provide strategic advice and counsel on ..
Job Information Humana Staff RX Clinical Programs Oncology Pharmacist in Minneapolis Minnesota Description The Staff RX Clinical Programs Oncology Pharmacist will be responsible for building relationships with oncology clinical practices that ..
... 3 years of experience in healthcare (billing, coding, auditing claims) 2 years ... Facets, Diamond, etc. or provider billing / coding knowledge on Professional ... and Facility claims) Understanding..
... and operational outcomes by combining healthcare experience and background with the ... Patient financial services (charge capture, pre-billing, billing, follow-up, cash posting, account resolution) ... Bachelor's degree in Business/..
... the only way to drive healthcare forward and remain a global ... clinic analysts, and financial and billing employees in clinics and hospitals. ... and payment advice in a..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. Responsibilities There are 4 shifts available for this role. All ..
Job Information Humana Manager, Fraud and Waste-Remote US in Minneapolis Minnesota Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Job Code 2172734I Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly ..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
Job ID 21000MX7Available Openings 1PURPOSE 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. ..