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Job Information Humana Healthcare Data Analyst in Louisville Kentucky ... in Louisville Kentucky Description The Payment Integrity Professional 2 uses technology ... and our financial recovery. The Payment Integrity Professional..
OverviewnPoint of contact for the billing scrubber system, responsible for running reports, creating edits and rules to improve the clean claim rate submission. Cross trained and assist in the billing for ..
Job Information Centerwell Medical Front Office Specialist - Outer Loop Clinic in Louisville Kentucky Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life ..
Description Humana Healthy Horizons in Kentucky is seeking a Community Health Worker to join our growing team. The Community Health Worker cultivates the organization's social community through community advocacy programs and ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Operations Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment ..
Description As a Senior Software Engineer within Centerwell Clinical IT engineering team, you will develop applications which have a distinct positive impact upon members services utilization and case management. He/ She ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Supervisor for Clinical Intake leads a team of Inbound Customer Service Representatives supporting the Medicaid segment. This group responds to provider calls and outreach and addresses needs which may ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
... 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 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 ..
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 Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Job Information Humana Supervisor, Care Management Support in Louisville Kentucky Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of ..
