- Merck & Co. (Rahway, NJ)
- …external medical and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs provide to ... interest to the company. The RMSD provides research support to our Investigator -Sponsored and Company-Sponsored Trials to enhance the understanding of the scientific… more
- Merck & Co. (St. Louis, MO)
- …and goals for approved, in-development, and active Company-sponsored trials and/or investigator -sponsored research studies. The RMSD serves as a role model for ... in the company's areas of interestScientific exchange does not include promotional claims about any drug, vaccine, or biologic product.-- RMSDs have no sales… more
- The Hartford (GA)
- …referred by the claim staff, or losses reviewed by the field investigator proactively which may be appropriate for SIU involvement. + The investigator ... SIU Investigator - CF08BE We're determined to make a...and General Liability. SIU Investigators work in partnership with claim handlers across all lines of business to investigate… more
- Travelers Insurance Company (Columbus, OH)
- …to uncover potentially fraudulent activity. The investigator , supporting a Claim Center, will investigate claims deemed suspicious in nature within ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...salary range provided for this position is a nationwide market range and represents a broad range of salaries… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit (SIU) Investigator , Sr. is to assist in the reduction and recuperation of losses ... of financial business records, provider and subscriber medical data, claims , systems? reports, medical records, analysis of contract documents, provider/subscriber… more
- Elevance Health (FL)
- ** Investigator Senior** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office)._ _Alternate ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- Elevance Health (Columbus, OH)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator Senior** **Location:** This position will work a hybrid model...of proprietary data and claim systems for review of facility, professional… more
- Elevance Health (Grand Prairie, TX)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Location** : This position will work a hybrid model...of proprietary data and claim systems for review of facility, professional and… more
- University of Rochester (Rochester, NY)
- …be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal ... the University community and meet the University's legal obligations to address claims of discrimination and harassment. Makes and documents findings that serve as… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- Social Services Lead Investigator - Child Support Hybrid Recruitment # 250124-7324SH-001 Location Bridgeport, CT Danbury, CT Hartford, CT Manchester, CT Middletown, ... and current DSS employees for a Social Services Lead Investigator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=7324SH&R1=&R3=) opportunity within our Child Support Division. This… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Special Investigator (General) Office/On-site Recruitment # 241218-7804AR-001 Location Hartford, CT Date Opened 1/13/2025 12:00:00 AM Salary $72,758* - $91,881/year ... dedicated individual to join our team as a Special Investigator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=7804AR&R1=&R3=) . This position will support DMHAS' Tobacco… more
- Elevance Health (Atlanta, GA)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may pose… more
- MyFlorida (Miami, FL)
- MEDICAL MALPRACTICE INVESTIGATOR - 64000552 Date: Jan 22, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 843392 Agency: Department of Health Working Title: MEDICAL MALPRACTICE INVESTIGATOR - 64000552 Pay Plan: Career Service Position Number: 64000552 Salary:… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …. As a member of Premera's Special Investigations Unit (SIU), the ** Investigator II** is responsible for developing, collecting, and evaluating information and data, ... as a fraud investigation. + Compile, manipulate, interpret, and document complex claims payment data to determine the company's potential financial exposure to a… more
- Highmark Health (Dover, DE)
- …Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment ... methodology, claims processing systems and coding and billing proficiency +...and expected contributions, as well as internal peer equity, market , and business considerations. The displayed salary range does… more
- Navy Federal Credit Union (Winchester, VA)
- Overview To identify, review, investigate fraud activity, claims /cases and risk exposures from various delivery channels. Review transactional activities, ... procedures + Review data gathered to substantiate/disqualify a loss claim or charge off, and escalate as needed +...on qualified applicant volume. Navy Federal Credit Union assesses market data to establish salary ranges that enable us… more
- Merck (Columbus, OH)
- …external medical and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs provide to ... interest to the company. The RMSD provides research support to our Investigator -Sponsored and Company-Sponsored Trials to enhance the understanding of the scientific… more
- Travelers Insurance Company (Hartford, CT)
- …Overview** The hourly salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across ... receiving valuable on-the-job training, and learns about the Fire Investigator professions available at Travelers. Interns receive challenging work...to the determination of an origin and cause fire claim , will also maintain a chain of custody of… more
- BlueCross BlueShield of North Carolina (NC)
- …Collaborate internally with other departments to create and maintain a seamless claims payment integrity program. Serve as liaison with other key departments ... (Medical Management, Network Management, Data Analytics, Claims & Enrollment Operations) to develop, monitor, and update respective roles, responsibilities, and… more
- Mount Sinai Health System (New York, NY)
- …goals related to contract yield, revenue growth, operational efficiencies and market share. 5. Collaborates cross- functionally internal stakeholders on more complex ... and address professional managed care contracts with regard to language, pricing, claims submission and appeals, claims adjudication and coverage policies, as… more
