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... contract is responsible for processing claims for more than 6 million ... than 6 million members, the claims processing and financial management functions ... to an external vendor. The..
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... Required Qualifications Bachelor's degree in Healthcare or equivalent years of experience ... RN license 2 years of healthcare experience within a fraud investigations ... well as solid knowledge of..
Job Information Humana Senior Fraud & Waste Investigator - Remote in Colorado Springs Colorado Description Are you looking to be a part of a Fortune 100 company with competitive salary, opportunity ..
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 ... support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... when they happen. The Nurse Auditor 2 validates..
Description Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... that our members receive quality healthcare at an affordable..
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 Medicaid Associate Director, Compliance Nursing in Colorado Springs Colorado Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
