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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 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 ..
Job Information Humana Inbound Contact Rep 2 - English OR Bilingual English and Spanish in Omaha Nebraska Description The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, ..
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 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. 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 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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
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)..
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 ..
... 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..
