- Humana (Raleigh, NC)
- …Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director reviews cases of diverse scope and complexity ... PHI / HIPAA information This is a remote position reporting to Grievance and Appeals Director or MD Team Lead **Scheduled Weekly Hours** 40 **Pay Range** The… more
- UNC Health Care (Chapel Hill, NC)
- …coder questions and provide training and education. This position processes and appeals insurance coding denials. This position analyzes coded records for compliance ... surgery, and ancillary cases). 3. Faxes, tracks, and monitors coding denials and appeals on both inpatient and outpatient cases. Reviews coding insurance denials and… more
- Humana (Raleigh, NC)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers… more
- Humana (Raleigh, NC)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... market, member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized team for several months… more
- UNC Health Care (Chapel Hill, NC)
- …the viability of any proposed changes to fee structures. 6. Prepares appeals of third party decisions. Conducts background research collects data assembles ... as liaison and manages records and files of such appeals . Directs mass claim refiles, 7. Recommends changes to...a Bachelor's degree: No experience required. * If an Associate 's degree: Four (4) years of experience in business… more
- Humana (Raleigh, NC)
- …Information** Typically reports to a Lead, may also report to a Regional/ Associate Vice President or Corporate Medical Director, depending on size of region ... market, member population, or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized team for several months… more
- Humana (Raleigh, NC)
- …population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more