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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 Network Operations Lead - Behavioral Health/Medicaid in Troy Michigan Description The Network Operations Lead maintains provider relations to support customer service activities through data integrity management and gathering ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Troy Michigan Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..
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 ..