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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 21000HVWAvailable Openings 1PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior ..
Job ID 21000N8VAvailable 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 policy requirements. Assists ..
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 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 ..
PURPOSE AND SCOPE: Performing general office duties incorporating a variety of basic and routine clerical and secretarial duties in a clinical environment.PRINCIPAL DUTIES AND RESPONSIBILITIES:Under direct/close supervision, performs a variety of ..
Job Information Centerwell RN Clinical Manager in Columbia South Carolina The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, and organizes ..
... 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 Centerwell Medical Records Specialist Home Health Full Time in North Charleston South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical ..
Job Information Centerwell RN Clinical Manager in Myrtle Beach South Carolina The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, 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 ..
Job Information Kindred at Home Medical Records Specialist in Anderson South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical Records department. Prepare ..
Job Information Centerwell Medical Records Specialist PRN in North Charleston South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical Records department. Depending ..
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 ..
Job Information Kindred at Home Medical Records Specialist in Seneca South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical Records department. Prepare ..
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 ..
Job Information Centerwell RN Clinical Manager Home Health Full Time in Orangeburg South Carolina The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, ..
... 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..
... 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..
Job Information Centerwell Medical Records Specialist in Cheraw South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical Records department. Prepare patient assessment ..
Job Information Centerwell Medical Records Specialist in Bluffton South Carolina The primary function of the Medical Records Specialist is to provide clerical support for the Medical Records department. Prepare patient assessment ..
Job Information Kindred at Home RN Clinical Manager in Rock Hill South Carolina The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, ..