Humana
Nurse Auditor
NewWhat's your preference?
Job Description
- Req#: R-405187
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $107,800 per year
- Eligible for a bonus incentive plan based on performance
- Comprehensive benefits package including medical, dental, and vision coverage
- Opportunities for personal wellness and smart healthcare decisions
- Flexible remote work arrangement
- Supportive work environment focused on employee well-being
What to Expect (Job Responsibilities):
- Validate and interpret medical documentation to ensure accurate coding and compliance
- Conduct reviews of provider codes and billing, focusing on laboratory services
- Audit claims related to genetics, drug testing, and infection agent testing
- Review cases of fraud, waste, and abuse, ensuring proper documentation and follow-up
- Collaborate with team members to enhance payment integrity processes
What is Required (Qualifications):
- Active RN license
- Experience with outpatient CPT/HCPCS codes
- Minimum of 2 years clinical experience
- At least 3 years' experience in the health industry
- Proficient in reviewing medical records
How to Stand Out (Preferred Qualifications):
- Certified Professional Coder (CPC)
- Familiarity with lab or genetic testing
- Experience in fraud, waste, and abuse investigations
- Clinical auditing experience
- Bachelor's degree
#Healthcare #Nursing #RemoteWork #CareerOpportunity #HealthIndustry
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.