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Current schedule not working with your family needs? You will work with our dedicated Scheduling Dept to make a schedule that works for you, your family, and the company. Not Feeling ..
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 Information Humana Home Care Scheduling Coordinator- Remote in Lancaster South Carolina Description SeniorBridge is hiring an experienced Homecare Scheduling Coordinator. SeniorBridge is Humana's wholly-owned home care business acquired in 2012. ..
Job Information Humana Associate Director, Site Reliability Engineering in Lancaster South Carolina Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
... 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 Lancaster South Carolina Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ..
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 ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Lancaster South Carolina Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
Job Information Humana Manager, Fraud and Waste-Remote US in Lancaster South Carolina Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
... 5 or more years of healthcare revenue cycle management experience may ... experience may suffice (to include, billing, coding, collections for Medicare and ... with Auditing and monitoring of..
Description Upstate South Carolina (Oconee County, Anderson, Greenville County) and Northeast GA (Madison, Elbert, Banks, Franklin County) The Medical Records Retrieval Specialist/ Risk Adjustment Representative 2 conducts quality assurance review of ..
Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..
... medical record documentation for incorrect billing and coding. The ideal candidate ... ensure capture of all relevant billing discrepancies. Identifies the root cause ... reviews of provider codes and..
... 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..
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 ..
Job Information Humana Home Health Aide, Full Time in Monroe North Carolina Description Home Health Aide 2 provides patients with assistance in activities in daily living. The Home Health Aide 2 ..
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 Information Humana Call Center Pharmacy Claims Technician in Lancaster South Carolina Description Job Description Summary The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The ..
Job Information Humana Risk Adjustment Representative 3- Scheduler in Lancaster South Carolina Description The Risk Adjustment Representative 3 (Scheduler) conducts quality assurance review of medical records and ICD-9/10 diagnosis codes that ..
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 ..
Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..