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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 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 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 ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Washington Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ... CPT, HCPCS). The..
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..
... 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..
... experience by increasing focus on healthcare services.nOperationsnResponsible for assisting pharmacist in ... of a pharmacist assists with healthcare service offerings including administering vaccines, ... the accurate processing of insurance..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Washington Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Portland Oregon ... Oregon Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Oregon 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..
Job Information Humana Manager, Fraud and Waste-Remote US in Vancouver Washington Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
... drug interactions and offering preventive healthcare services such as immunizations. Responsible ... experience by increasing focus on healthcare services (e.g. patient consultation, medication ... as requested by Store Manager,..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Portland Oregon ... Oregon Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Vancouver Washington ... Washington 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 ... coding guidelines. The Medical Coding Auditor work assignments are varied and ... guidelines/procedures. As a Medical Coding Auditor for..
Job Information Humana Manager, Fraud and Waste-Remote US in Portland Oregon Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
... 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..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Vancouver Washington ... Washington 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 ..
... 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..
