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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 ..
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 ..
Description The Nurse Auditor 2 performs clinical audit/validation processes ... support optimal reimbursement. The Nurse Auditor 2 work assignments are varied ... is looking for a Nurse Auditor 2 Professional..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
... Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in ... Michigan Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors. This ..
Job Information Humana Licensed Behavioral Health Professional - Quality Audit in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Licensed Behavioral Health Quality Audit Professional. This position ensures ..
Job Information Humana Senior Compliance Registered Nurse in Troy Michigan Description Humana Healthy Horizons in Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory reporting for Case Management and ..
... Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Troy Michigan ... Michigan Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
... Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Troy Michigan ... Michigan Description The Medical Coding Auditor extracts clinical information from a ... patient records. The Medical Coding..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
