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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 ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
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 ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Jersey City New Jersey Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ..
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 ..
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 ..
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 ..
... 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..
Posted: 23-Feb-22 Location: Jersey Shore, Pennsylvania Type: Part Time Salary: Open Categories: General Nursing Internal Number: R-23128 Job Summary Phlebotomist II is responsible and accountable for performing a wide range of ..
Job Information Humana Associate Director, Site Reliability Engineering in Jersey City New Jersey Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate ..
... 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 Manager, Fraud and Waste-Remote US in Jersey City New Jersey Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud ..
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 ..
... 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..
Multiple Wound Care (Full-Time & Part-Time) Opportunities in Northern New Jersey - Near NYC!!Group - the Standard of Excellence in Wound Care in Northern New Jersey - invites you to join ..
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 ..
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 ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Jersey City New Jersey Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical ..
