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Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
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 Medicaid Associate Director, Compliance Nursing in Honolulu Hawaii Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... that our members receive quality healthcare at an affordable..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Hawaii Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding Auditor work assignments are varied and ... for an experienced medical coding auditor to..
Job Information Humana Manager, Fraud and Waste-Remote US in Honolulu Hawaii Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
... when they happen. The Nurse Auditor 2 validates and interprets medical ... of par and non-par provider claims to determine payment accuracy. Makes ... process improvements. Reviews and audits..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Honolulu Hawaii ... Hawaii Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Hawaii Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Honolulu Hawaii ... Hawaii Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
