- Humana (Montpelier, VT)
- …claims in accordance with TRICARE policy requirements. This role involves reviewing pre -payment, high dollar claims to assess payment accuracy and identify ... **Become a part of our caring community and help us put health first** The Claims Risk Management Professional is responsible for ensuring payment quality of … more
- Humana (Montpelier, VT)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... metrics-driven environment. If you are looking to work from home , for a Fortune 100 company that focuses on...payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments.… more
- Humana (Montpelier, VT)
- … healthcare fraud investigations and auditing experience * Knowledge of healthcare payment methodologies, claims , submissions, and payments * Strong ... skills to make an impact** **WORK STYLE:** Work at Home . While this is a remote position, occasional travel...AHFI) * Experience testifying in court * Understanding of healthcare industry, claims processing, and investigative process… more
- Humana (Montpelier, VT)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + ... + Bachelor's degree + Minimum 3 + years of healthcare fraud investigations and auditing experience + Knowledge of...operations + Bilingual in Spanish **Additional Information** **Work at Home Requirements** * At minimum, a download speed of… more
- Humana (Montpelier, VT)
- …escalations. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home . While this is a remote position, occasional travel to Humana's offices for ... certification experience utilizing coding guidelines by reading and interpreting claims + Exceptional understanding of Centers for Medicare &...hours are 8AM - 5PM Eastern time. **Work at Home Requirements** * At minimum, a download speed of… more