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Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... variable factors. Responsibilities Job Title:..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
... team with an Inpatient Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 ... verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are ... Where you Come In The..
... CGX and faxing to Humana Medical Directors for approval or denial ... experience Excellent verbal and written communication skills Ability to demonstrate excellent ... demonstrate excellent verbal and written..
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. ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what ... this information confidently to other..
... conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes ... (Scheduler) ensures sites with open medical records requests are contacted in ... care (provider office, billing, coding,..
Job Information Humana Senior Accreditation Professional in Albany New York Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance ..
Description The Medical Record Retrieval Representative (Risk Adjustment ... within the region and scans medical records into a secure system. ... accrual Tuition Reimbursement Responsibilities The Medical Records Retrieval Representative..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
... the team with a Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities Job Profile The..
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 ..
