Virtual Healthcare Jobs in Troy

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 to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..

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 ..

... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... a Bachelor's degree in Business, Healthcare, or related field and/or 8 ... 5 years' experience in the..

Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..

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. Responsibilities ..

Description The Medical Records Retrieval Representative travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Responsibilities The ..

Description The Integrated Model for D-SNP team is focused on delivering an integrated member experience through a multidisciplinary team. Focused on the highest risk D-SNP members, this team coordinates both inbound ..

Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Troy Michigan Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..

Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..

Description Humana is seeking a Physician Strategy Sr. Professional to join our growing team. The Physician Strategy professional will be responsible for setting and implementing strategy for internal and external physician ..

Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Troy Michigan Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

Description Are you passionate about discovering opportunities to improve coding efficiencies and mentoring application developers in proper coding techniques for mainframe programs? Do you have a solid Cobol, DB2, and CICS ..

Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Troy Michigan Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..

Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Troy Michigan Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..

Description The DRG Validation 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 ..

Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Troy Michigan Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..

... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..

... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..

Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..

Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..

Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..