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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)..
Job Information Humana Manager, Specialty Pharmacy Sales in Green Bay Wisconsin Description The Manager, Pharmacy Sales - Specialty leverages targeted geographic analysis, engages with Physician offices to influence physicians to route ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Green Bay Wisconsin Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience ..
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 ..
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 ..
... Do you love researching, analyzing medical documents to determine if something ... considered yourself a detective for medical claims / member benefits? Well, ... your help with: Managing client..
Job Information Humana Bilingual Medicare Sales Field Agent (English / Vietnamese / Laotian) in Green Bay Wisconsin Description Are you passionate about the Medicare population, looking for an opportunity to work ..
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 Bilingual Medicare Sales Field Agent (English / Vietnamese / Laotian) - Green Bay, WI in Green Bay Wisconsin Description Are you passionate about the Medicare population, looking for ..
Description Humana is seeking a Housing Navigator to join the Wisconsin Medicaid Market (iCare) team. The Housing Navigator manages and monitors housing or re-housing services for members which involves orienting all ..
Description Humana/iCare is seeking a Community Engagement Specialist to join our growing team in the Wisconsin Medicaid Market. The Community Engagement Specialist establishes and cultivates the organization's relationships with key community ..
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) -Remote, anywhere with-in Eastern Time Zone in Green Bay Wisconsin Description The Quality (Non-Calls) Professional 2 ensures that products meet specific ..
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 . 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 Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Green Bay Wisconsin Description The Quality (Non-Calls) Professional 2 ensures that ..
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 ..
... 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 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 ..
