Humana Inc

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

A health insurance provider is seeking a Senior Provider Reimbursement Professional to oversee provider reimbursement programs. The role requires a coding certification and 2 years of experience in medical claims processing. Responsibilities include policy recommendations and analysis of reimbursement trends. This position offers remote work flexibility and a competitive salary ranging from $59,300 to $80,900 annually, along with a bonus incentive plan. #J-18808-Ljbffr

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

A leading health insurance company is looking for a Senior Provider Reimbursement Professional. In this remote role, you will perform analysis, maintain compliance with regulations, and influence departmental strategies. The ideal candidate has coding certification, experience in claims processing, and knowledge of reimbursement methodologies. Competitive benefits include health insurance, retirement plans, and more. #J-18808-Ljbffr

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes...