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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 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'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 ..
PURPOSE AND SCOPE:Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient ..
Job Information Humana Manager, Fraud and Waste-Remote US in Beckley West Virginia Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Job Information Humana Manager, Fraud and Waste-Remote US in Huntington West Virginia Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud 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 ..
... 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..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. This position is for Enclara Pharmacia, a Humana company. Enclara, ..
... 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,..
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 ..
Description SeniorBridge is hiring a remote, Full-Time Scheduling Coordinator. SeniorBridge is Humana's wholly-owned home care business acquired in 2012. We provide concierge care management, private duty nursing, and personal care assistance ..
Job Information Humana Manager, Fraud and Waste-Remote US in Morgantown West Virginia 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 Charleston West Virginia Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
... 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..
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 ..
... 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..
Job Information Humana Manager, Fraud and Waste-Remote US in Charleston West Virginia Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Job Information Kindred at Home RN Clinical Manager in Beckley West Virginia The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, ..
