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Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This role will focus on..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Brentwood Tennessee Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns..
Job Information Humana Quality Assurance Audit Professional 2 in Brentwood Tennessee Description Humana's Marketing Operations Quality Audit team is looking for a Quality Assurance Audit Professional 2 to join working..
Description The Claims Quality Audit Representative 3 audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. The Claims Quality Audit Representative 3 performs advanced..
Description Humana's Internal Audit team provides independent objective assurance and consulting services that are designed to validate design and operating effectiveness as well as improve controls, operations, and risk management...
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor,..
Job Information Humana Manager, Compliance - Agent Investigation Unit in Brentwood Tennessee Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures;..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Brentwood Tennessee Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Brentwood Tennessee Description The Medical Coding Auditor reviews medical claims submitted against medical records..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records, and reviews medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical..
Job Information Humana Senior IT Compliance Professional- Controls Management (Remote / Virtual) in Brentwood Tennessee Description We are looking for a talented risk and compliance expert to help build a..
Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guideline are met. The Medical Coding Auditor work assignments are varied and frequently..
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..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and..
Description The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Senior Risk Management Professional work assignments involve moderately complex to complex issues where..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement...
Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The..
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..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Brentwood Tennessee Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural..
Job Information Humana Bilingual Quality Auditor in Brentwood Tennessee Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality...
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..
