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Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g. CPT)..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... in reviewing actual and proposed medical care and services against established ... against established CMS and Humana..
Job Information Humana Subrogation Professional 2-WAH in US in Aberdeen South Dakota Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying ..
Description . Responsibilities The Process Improvement Lead researches best business practices within and outside the organization to establish benchmark data. This individual collects and analyzes process data to initiate, develop and ..
Description Responsibilities The Payment Integrity Professional 2 contributes to overall cost reduction, by increasing the accuracy of provider payments in our payer systems, and by ensuring correct claims payment. This position ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Job Information Humana Oncology Market Director in Aberdeen South Dakota Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Job Information Humana Manager, Utilization Management RN - Remote in Aberdeen South Dakota Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Description The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Aberdeen South Dakota Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience ..
... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... Behavioral Health Professional 2 completes medical record reviews from medical records sent from Behavioral Health ... appropriate..
Description The Subrogation Professional II identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... coordination, documentation, and communication of medical services. Enjoy the flexibility of ... Management Behavioral Health Nurse completes medical record reviews from medical records sent from Behavioral Health ... of..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
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 ..
Job Information Humana Subrogation Professional 2 Remote/WAH in USA in Aberdeen South Dakota Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for ..
Job Information Humana Social Media Representative 3 - Remote in US in Aberdeen South Dakota Description The Social Media Representative 3 protects company's brand image by monitoring and addressing social media ..
Job Information Humana Utilization Management Registered Nurse - Remote in Aberdeen South Dakota Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical ..
Job Information Humana Manager, Specialty Pharmacy Sales in Aberdeen South Dakota Description The Manager, Pharmacy Sales - Specialty leverages targeted geographic analysis, engages with Physician offices to influence physicians to route ..
... OR Provide documentation for a medical or religious exemption consideration. This ... coordinating the intake of necessary medical documents, completing letter templates, and ... Preferred Qualifications Proficient utilizing electronic..
