Healthcare Credentialing Jobs in Riverton

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 Innovation. Automation. Collaboration. Creation. These are just a few words that could describe your next opportunity. Humana is looking for a credentialed actuary that takes pride in their ability to ..

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 Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Locum Hospitalist needed for Day shift and call at night.-Coverage: Hospitalist-Dates: March/April Start-Credentialing takes 30-45 days-License: Prefer WY license. Will review candidates who -need WY license-Work Schedule: 10 shifts per month ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

Description The Network Operations Coordinator 3 manages provider data including but not limited to demographics and contract accuracy. Additional Information - How we Value You Benefits starting day 1 of employment ..

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 Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Coverage:HospitalistDates:March/April StartCredentialing takes 30-45 daysWork Schedule: 10 shifts per month needed days 7a-7p then call 7p-7a: phone triage. 1-3 calls per night. Physician sometimes will return to the hospital specifically with ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..