Healthcare Documentation Specialist Jobs in Pittsburgh

Coding Specialist We have exciting employment opportunities ... Position Summary The HIM Coding Specialist will handle medical coding and ... and procedure codes based upon documentation in the medical record..

AdvantageCare Rehabilitation is now hiring a Nurse Consultant Clinical Reimbursement Specialist to oversee our facilities in Western PA. This is a home based position, but travel throughout Western, PA and surrounding ..

Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..

Job Information Humana Medical Director - S. Florida in Pittsburgh Pennsylvania Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

... of coding practices and clinical documentation, grievance and appeals processes, and ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..

... Information Humana Pharmacy Technician Networks Specialist, Remote PA or NJ in ... assignments. Responsibilities The Pharmacy Networks Specialist (Provider Contracting Administration Coordinator 2) ... compliance packaging. Ensure that all..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Pittsburgh Pennsylvania Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

We have an immediate opportunity for Case Managers. General Summary: The Case Manager coordinates and manages services provided to each patient to establish a focused, individualized program geared towards specific goals ..

We have an immediate opportunity for an Director of Admissions General Summary: The Director of Admissions is responsible for the hospital’s overall admission process and staff. The Director of Admissions is ..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... Qualifications Bachelor's degree or significant..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Pittsburgh Pennsylvania Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..

... is looking for an experienced Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... areas Bachelor's degree or significant..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..

Job Information Humana Medicare Appeals and Grievance Medical Director in Pittsburgh Pennsylvania Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

Job Information Humana FP&A Lead, Medicaid Market in Pittsburgh Pennsylvania Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

Description Job Description Summary 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 ..

Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Pittsburgh Pennsylvania Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..

We have an immediate opportunity for Admissions Representatives General Summary: The Admissions Representative serves as the coordination point for referring facilities, physicians, payors and families by coordinating all aspects of referral/admission ..

We have an immediate opportunity for Admissions Coordinator The Admissions Coordinator serves as the point of contact for the clinical assessment process. Assesses by phone the needs of patient, collecting data ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Pittsburgh Pennsylvania Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..