HealthcareCrossing Jobs

Nurse Auditor 2/RN (Coding and Home Health Field exp a MUST) Work At Home - USA-ME-Portland

Sun, 13 Aug 2023 00:00:00 CDT

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...

Outpatient Medical Coding Auditor-Remote/Virtual in US - USA-ME-Portland

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records a...

Inpatient Medical Coding Auditor-Remote/Virtual in US - USA-ME-Portland

Thu, 23 Mar 2023 00:00:00 CDT

Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Portland Maine Description The Medical Coding Auditor extracts clinical information from a variety of medical records an...

Senior Clinical Fraud and Waste Investigator - RN and Coding Credential required - REMOTE (Anywhere in US) - USA-ME-Portland

Fri, 07 Apr 2023 00:00:00 CDT

Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Profe...

Senior Risk Management Professional - Third Party Risk Management-Remote, US - USA-ME-Portland

Fri, 07 Apr 2023 00:00:00 CDT

Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Portland Maine Description The Senior Risk Management Professional a critical member within Human...

Director, Behavioral Health Strategy - USA-ME-Portland

Wed, 13 Apr 2022 00:00:00 CDT

Job Information Humana Director, Behavioral Health Strategy in Portland Maine Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have acce...

Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US - USA-ME-Portland

Sun, 10 Apr 2022 00:00:00 CDT

Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Portland Maine Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record...

Manager, Fraud and Waste-Remote US - USA-ME-Portland

Mon, 25 Apr 2022 00:00:00 CDT

Job Information Humana Manager, Fraud and Waste-Remote US in Portland Maine Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Man...

Compliance Registered Nurse, RN, 2 - South Carolina Medicaid - USA-ME-Portland

Mon, 25 Apr 2022 00:00:00 CDT

Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and...

Compliance Nursing Supervisor - USA-ME-Portland

Mon, 02 May 2022 00:00:00 CDT

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud...

Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME - USA-ME-Portland

Mon, 29 Aug 2022 00:00:00 CDT

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Portland Maine Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry ...

Nurse Auditor 2 PPI Lab Remote MST, CST, EST - USA-ME-Portland

Mon, 24 Oct 2022 00:00:00 CDT

Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. ...

Compliance and Process Improvement Professional Registered Nurse, RN - USA-ME-Portland

Sat, 26 Nov 2022 00:00:00 CST

Fraud and Waste Investigator - Work At Home (Anywhere in the US) - USA-ME-Portland

Mon, 05 Dec 2022 00:00:00 CST

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Portland Maine Description Humana is looking for an experienced Healthcare Investigator to join its industry ...

DRG Validation Coding Auditor - USA-ME-Portland

Sat, 22 Apr 2023 00:00:00 CDT

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 pa...

Inpatient Medical Coding Auditor - USA-ME-Portland

Thu, 20 Apr 2023 00:00:00 CDT

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, CPT) to patie...

Enterprise Risk Management Lead-US-Remote - USA-ME-Portland

Thu, 11 May 2023 00:00:00 CDT

Job Information Humana Enterprise Risk Management Lead-US-Remote in Portland Maine Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program ...

Nurse Auditor Review - USA-ME-Portland

Thu, 11 May 2023 00:00:00 CDT

Bilingual Quality Auditor - USA-ME-Portland

Sat, 03 Jun 2023 00:00:00 CDT

Job Information Humana Bilingual Quality Auditor in Portland Maine Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Servi...

Clinical Physician Assistant - Mental Health - Rumford CBOC - USA-ME-Rumford

Mon, 05 Jun 2023 00:00:00 CDT

Qualifications \n
\n \n Applicants pending the completion of educational or certification/licensure requirements ...