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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 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 ..
Job Information Humana Associate Director, Site Reliability Engineering in Montpelier Vermont Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Montpelier Vermont Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
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 ..
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 Genetic Counselor (Board Certified)-Remote/Virtual in US in Montpelier Vermont Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... provider records ensuring appropriateness of billing practices. Prepares complex investigative and ... Qualifications Bachelor's degree or significant..
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 ..
Genex Service LLC Field Case Manager 2 US-VT-Burlington Job ID: 22-13221 Type: Regular Full-Time # of Openings: 1 Category: Case Management Mitchell International Overview The Enlyte Family of Businesses Mitchell | ..
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 ..
Job Information Humana Manager, Fraud and Waste-Remote US in Montpelier Vermont Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Sign On Bonuses for RN's and LPN's! Full Time: $10,000 Part Time: $5,000 Put your licensed practical nursing skills to a different use as a MDS Coordinator at Genesis! We are ..
... 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..
Sign On Bonuses for RN's and LPN's! Full Time: $10,000 Part Time: $5,000 POSITION SUMMARY: The Clinical Reimbursement Coordinator (RN) manages the overall process and tracking of all Medicare/Medicaid case-mix documents ..
... is a leading provider of healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion! We Care ... that is responsible for census,..
... 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..
