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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)..
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 Subrogation Professional 2 Remote/WAH in USA in Brentwood Tennessee Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying ..
Description The Grievances & Appeals Representative 4 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Supervisor, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is warranted ..
Job Information Humana Manager, Specialty Pharmacy Sales in Brentwood Tennessee Description The Manager, Pharmacy Sales - Specialty leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' ..
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 Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Brentwood Tennessee Description The Quality (Non-Calls) Professional 2 ensures that products ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
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 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. ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Brentwood Tennessee Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..
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 Bilingual Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further ..
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 ..
Job Information Humana Grievances & Appeals Representative 4 (FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Brentwood Tennessee Description The Grievances & Appeals Representative 4 manages client medical denials ..
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 ..
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 ..
Job Information Humana Medical Claims Processing Representative 2 in ... in Brentwood Tennessee Description The Medical Claims Processing Representative 2 reviews ... Go365 perks for well-being Responsibilities Medical Claims Processing..
... 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 Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Senior Utilization ..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -Remote, anywhere with-in Eastern Time Zone in Brentwood Tennessee Description The Quality (Non-Calls) Professional 2 ensures that products meet specific Centers ..
