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Description The RN, 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 abuse. The RN ..
Description The Subrogation Professional 2 iIdentifies, 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 ..
Job Information Humana OB Care Management Support Assistant 2/Medicaid (Bilingual English/Spanish or Creole) Remote FL in Saint Augustine Florida Description The Care Management Support Assistant 2 contributes to administration of care ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Job Information Humana Supervisor, Grievances & Appeals in Saint Augustine Florida Description The Supervisor, Grievances & Appeals works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable ..
... Excel and Outlook Proficient with medical terminology Experience with Electronic Medical Records Excellent professional communication abilities, ... and CPT coding Referral experience Medical Assistant or Professional State Certifications .....
