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Description Humana's recently created Clinical Resource Team is looking to grow the team with a couple Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly ..
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... provider records ensuring appropriateness of billing practices. Prepares complex investigative and ... Required Qualifications Bachelor's degree in Healthcare or equivalent years of experience ... RN license 2 years of..
Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description Our search is focused on identifying a certified coder who will primarily be responsible for conducting prospective and concurrent reviews to identify documentation improvement opportunities according to CMS and ICD-10 ..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
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 Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team working remote/from home anywhere in the U.S. Responsibilities As a Board Certified ..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a ..
Description Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical best ..
