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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 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 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 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 Responsibilities The Claims Quality Audit Professional 1 works with the Resolution Quality Audit leadership team to support efficiency and day to day operations. Requires in-depth knowledge of Microsoft products..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Indianapolis Indiana Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience..
Job Information Humana Senior IT Compliance Professional- Controls Management (Remote / Virtual) in Indianapolis Indiana Description We are looking for a talented risk and compliance expert to help build a..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Indianapolis Indiana Description The Medical Coding Auditor reviews medical claims submitted against medical records..
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 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 Quality Audit Professional 2 (Grievance & Appeals) -(FULLY BILINGUAL English/Spanish) Remote, anywhere with-in Eastern Time Zone in Indianapolis Indiana Description The Quality (Non-Calls) Professional 2 ensures that..
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 Compliance Registered Nurse in Indianapolis Indiana Description Humana Healthy Horizons in Ohio is seeking a Senior Compliance Nurse. This position ensures mandatory reporting for Case Management..
Job Information Humana Manager, Compliance - Agent Investigation Unit in Indianapolis Indiana Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures;..
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 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..
Job Information Humana Quality Audit Professional 2 (Grievance & Appeals) -Remote, anywhere with-in Eastern Time Zone in Indianapolis Indiana Description The Quality (Non-Calls) Professional 2 ensures that products meet specific..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Indianapolis Indiana Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural..
Job Information Humana Clinical Auditor Registered Nurse Care Management or Utilization Management in Indianapolis Indiana Description Humana Healthy Horizons in Ohio is seeking a Utilization and Case Management Clinical Auditors...
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 Inpatient Medical Coding Auditor-Remote/Virtual in US in Indianapolis Indiana 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 Indianapolis Indiana Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality...
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...