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... contract is responsible for processing claims for more than 6 million ... than 6 million members, the claims processing and financial management functions ... to an external vendor. The..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... when they happen. The Nurse Auditor 2 validates..
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 ..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Kentucky Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
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..
... to efficiently submit medical insurance claims for all payers including Medicare ... billing workload.n Monitor and resolve claims holding on discharged not final ... standards of compliance.n Assure all..
Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... are met. The Medical Coding Auditor work assignments are varied and ... action. Responsibilities The Medical..
Description The Medical Coding Auditor extracts clinical information from a ... coding guidelines. The Medical Coding Auditor work assignments are varied and ... guidelines/procedures. As a Medical Coding Auditor for..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description The Nurse Auditor 2 will work on the ... lab audit concepts. The Nurse Auditor 2 will perform clinical audit ... waste, and abuse. The Nurse Auditor 2 work..
Description Responsibilities The Claims Quality Audit Professional 1 works with the Resolution Quality Audit leadership team to support efficiency and day to day operations. Requires in-depth knowledge of Microsoft products Excel, ..
Job Information Humana Medical Coding Auditor (Evaluation & Management experience required) ... Kentucky Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... are met. The..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Kentucky Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Lexington Kentucky ... Kentucky 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..
Description The Director HEDIS Production and Quality Analytics takes the lead in driving success for key quality measures development and analytic reporting functions that support Humana Military clinical quality strategies, including ..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Lexington Kentucky ... Kentucky Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Louisville Kentucky ... Kentucky Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Oversight to the WPS Duplicate Claims System load completion to meet ... to include oversight of Duplicate Claims System. Vendor management of WPS ... also coordinate related efforts with..
... 5 or more years of healthcare revenue cycle management experience may ... for Medicare and Medicaid related claims) Experience with Auditing and monitoring ... with Auditing and monitoring of..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Louisville Kentucky ... Kentucky Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
