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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)..
... 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..
Job Information Humana Manager, Utilization Management RN - Remote in Montpelier Vermont Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical ..
... 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 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 ..
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 ..
Job Information Humana Manager, Specialty Pharmacy Sales in Montpelier Vermont Description The Manager, Pharmacy Sales - Specialty leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Montpelier Vermont Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..
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 ..
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 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 ..
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 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 facilitate ..
The Department of Multilingual Learners Program Assistant is a non-aligned, non-exempt/hourly position that will report to the Director of Programs for Multilingual Learners. The Program Assistant will conduct regional and national ..
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 ..
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 ..
Job Information Humana Subrogation Professional 2 Remote/WAH in USA in Montpelier Vermont Description The Subrogation Professional 2 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying ..
Professional, Web Content & French CA Translations (Remote) Date: May 31, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a commitment ..
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 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 ..
