Healthcare Compliance Auditor Jobs in Pennsylvania

... Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description ... Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..

Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..

Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..

Job Information Humana Senior Compliance Registered Nurse in Pittsburgh Pennsylvania ... Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory ... timely and accurately. Responsibilities Senior Compliance Nurse..

Job Information Humana Bilingual Quality Auditor in Pittsburgh Pennsylvania Description The ... Pennsylvania Description The Bilingual Quality Auditor/ Professional 2 ensures that products ... ensure accuracy. Responsibilities Bilingual Quality Auditor/..

Description The Behavioral Health Parity Compliance Lead will play an integral ... of our Mental Health Parity Compliance Program. Responsibilities This role is ... Healthy Horizons Mental Health Parity Compliance..

Job Information Humana HCS Compliance & Risk Management Quality Audit ... action. Responsibilities As a HCS Compliance & Risk Management Quality Audit ... be responsible for executing the Compliance Oversight..

Description Responsibilities The Compliance Professional 2 has responsibilities for ... documentation for quality and clinical compliance with contract requirements as outlined ... ensure all providers are in compliance based on..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty ... Pennsylvania Description The Medical Coding Auditor reviews medical claims submitted against ... CPT, HCPCS). The Medical Coding Auditor..

Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior ... with governmental requirements. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities Seeking Senior..

Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Pittsburgh Pennsylvania Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management ..

Hospital Coding Auditor (IP/OP) - Remote Location : ... and Advisory Services. The Coding Auditor ensures that coding compliance initiatives are met for our ... and other factors. The Coding..

Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..

Location27 East Main Street - North East, Pennsylvania 16428 Job Summary Be a problem solver, trusted advisor, and partner to the people and businesses in our Key Bank communities. The Private ..

Description The DRG Validation Auditor extracts clinical information from a ... patient records. The Medical Coding Auditor work assignments are varied and ... action. Responsibilities The DRG Validation Auditor confirms..

Job Information Humana Licensed Behavioral Health Professional - Quality Audit in Pittsburgh Pennsylvania Description Humana Healthy Horizons in Ohio is seeking a Licensed Behavioral Health Quality Audit Professional. This position ensures ..

Description The Supervisor, Compliance Nursing reviews utilization management activities ... waste, and abuse. The Supervisor, Compliance Nursing works within thorough, prescribed ... analytical approach. Responsibilities The Supervisor, Compliance Nursing ensures..

... looking for an experienced Senior Healthcare Investigator to join its industry ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..

... is looking for an experienced Healthcare Investigator to join its industry ... a thorough investigation to maintain compliance with Humana and governmental requirements ... external partners (Law Enforcement, Legal,..

Description The Compliance Nurse 2 reviews utilization management ... fraud, waste, and abuse. The Compliance Nurse 2 work assignments are ... appropriate courses of action. The Compliance Nurse 2 will..

... and Advisory Services. The Coding Auditor ensures that coding compliance initiatives are met for our ... and other factors. The Coding Auditor will have the following responsibilities: ... following..

Description Senior Compliance Professional ensures compliance with governmental requirements as they ... Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities The Senior Compliance..

Job Information Humana Clinical Auditor Registered Nurse Care Management or ... is completed. Conducts and summarizes compliance audits. Responsibilities The Clinical Auditor for the Care and or ... physician office,..