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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 ..
Behavioral Health Program Development Manager (Full Time) Location: Providence,RI Seeking a self-motivated and organized Behavioral Health Program Development Manager to work in our busy Acute Services division. The Program Development Manager ..
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 ..
... 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 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 ..
... Options Search Career Opportunities Hire Healthcare Professionals Pay My Bill Find ... RI, 02818 School - ST, Healthcare Contract - Full Time I'm ... Full Time I'm Interested Maxim..
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 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 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 ..
Genesis is one of the nations' leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how ..
Genesis HealthCare is one of the nation's ... the nation's leading providers of healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion!We Care..
Job Information Humana Manager, Fraud and Waste-Remote US in Newport Rhode Island 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..
WalgreensnJob DescriptionIn accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy. Assists the pharmacist in the performance of other Pharmacy Department duties in ..
... is a leading provider of healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion! We Care ... that is responsible for census,..
President and CEO Horizon Healthcare Partners (Full Time) Location: East ... East Providence, RI Unique Behavioral Healthcare Leadership Opportunity Horizon Healthcare Partners (HHP) is conducting a ... grow a comprehensive..
Job Information Humana Associate Director, Site Reliability Engineering in Newport Rhode Island Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Newport Rhode Island Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ..
... East Providence, RI Unique Behavioral Healthcare Leadership Opportunity Horizon Healthcare Partners (HHP) is conducting a ... grow a comprehensive state-wide behavioral healthcare and human service network that ... sources...
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 ..
Health Information Specialist (Full Time) Location: East Providence, RI The BH Link is searching for an enthusiastic professional who is looking to make a positive impact in the Rhode Island community! ..
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 ..
