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Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied..
Description Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Medical Coding Auditor roles! This is a unique team that's primary role is to..
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 Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and..
Job Information Humana Senior Compliance Registered Nurse in Charleston West Virginia Description Humana Healthy Horizons in Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory reporting for Case..
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,..
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..
Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of..
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..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Charleston West Virginia Description The Medical Coding Auditor reviews medical claims submitted against medical..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the..
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 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 Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Charleston West Virginia Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review..
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..
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 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..
