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Description The Field Care Manager NP assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for ..
Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework ..
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)..
Job Information Humana Inbound Contact Rep 2 - English OR Bilingual English and Spanish in Cincinnati Ohio Description The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, ..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... in reviewing actual and proposed medical care and services against established ... against established CMS and Humana..
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 ..
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 Job Summary 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 ..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
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 ..
