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Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
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 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. Responsibilities ..
Job Information Humana Manager, Fraud and Waste-Remote US in Portsmouth New Hampshire Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Job Information Humana Associate Director, Site Reliability Engineering in Portsmouth New Hampshire Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..
... medical record documentation for incorrect billing and coding. The ideal candidate ... ensure capture of all relevant billing discrepancies. Identifies the root cause ... reviews of provider codes and..
At Wentworth-Douglass, we value people who contribute to patient-centered care that enhances community health; we recognize and reward those who share our values and transform our patients' lives. We invite you ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
... is looking for an experienced Healthcare Investigator to join its industry ... provider records ensuring appropriateness of billing practices. Prepares investigative and audit ... areas Bachelor's degree or significant..
Job Information Humana Staff RX Clinical Programs Oncology Pharmacist in Portsmouth New Hampshire Description The Staff RX Clinical Programs Oncology Pharmacist will be responsible for building relationships with oncology clinical practices ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Portsmouth New Hampshire Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ..
WalgreensnJob DescriptionOur pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll ..
Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll be ..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. Responsibilities There are 4 shifts available for this role. All ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Portsmouth New Hampshire Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
... Options Search Career Opportunities Hire Healthcare Professionals Pay My Bill Find ... ME, 04403 School – ST, Healthcare Contract - Full Time I'm ... Full Time I'm Interested Maxim..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
