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Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Job Location Washington D.C.- 6900 - Washington, DC Position Type Full Time Salary Range $17.00 - $18.00 Hourly Travel Percentage Up to 50% There's a spot on our team waiting for ..
Speech/Language Pathologist- PRN','2300011R','!*!Responsible for evaluating speech/language of children and providing remediation for children with communication disorders. PRN- As Needed ','!*!Minimum EducationMaster's Degree (Required)Minimum Work Experience0 years Will consider recent Master’s Level ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Washington District Of Columbia Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Speech/Language Pathologist- PRN- SRC','23000128','!*!Responsible for evaluating speech/language of children and providing remediation for children with communication disorders. PRN- As Needed ','!*!Minimum EducationMaster's Degree (Required)Minimum Work Experience0 years Will consider recent Master’s ..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
... computer system information. Review patient insurance information for accuracy, collect demographic ... for accuracy, collect demographic and insurance information, checks/corrects facesheet. Verify the ... information, checks/corrects facesheet. Verify the..
... leader in medical technology and healthcare solutions.** **Rooted in our long ... driver's license and active vehicle insurance policy. In addition, your driving ... MEDTRONIC** Together, we can change..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Job Location Washington D.C.- 7200 - Washington, DC Position Type Full Time Salary Range $38,000.00 - $41,000.00 Salary/year There's a spot on our team waiting for you! Become a Team Leader ..
Job Location Washington D.C.- 6900 - Washington, DC Position Type Full Time Salary Range $37,000.00 - $38,000.00 Salary/year There's a spot on our team waiting for you! Become a Team Leader ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
