- CVS Health (Frankfort, KY)
- …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
- Molina Healthcare (Lexington, KY)
- …programs. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims...audit , provider disputes, appeals, and 1500 & UB04 claim experience are highly preferred. Ability to apply state… more