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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 ..
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 ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Portland Maine Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..
Job Information Humana Utilization Management Registered Nurse, RN 2 in Portland Maine Description The Utilization Management Nurse applies a Person-Centered approach, works within specific guidelines and procedures; applies advanced technical knowledge ..
Job Information Humana Network Operations Lead - Behavioral Health/Medicaid in Portland Maine Description The Network Operations Lead maintains provider relations to support customer service activities through data integrity management and gathering ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records, and reviews medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding ..