- Option Care Health (Chicago, IL)
- …areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse . Coordinates with internal stakeholders to identify audit ... in compliance requirements related to billing and coding, privacy and security, and fraud , waste and abuse , including but not limited to HIPAA, Anti-Kickback,… more
- Option Care Health (Springfield, IL)
- …subject matter expert in health care compliance including, but not limited to fraud , waste and abuse ; Medicare & Medicaid billing requirements; and interactions ... and retaining a diverse workforce. COVID-19 Vaccine Requirements:As a leading healthcare provider, we have an undeniable responsibility to protect the health… more
- MultiPlan (Atlanta, GA)
- …and Analytics ecosystem.2. Understand claims flow, savings identification, appeals processing, and fraud , waste, and abuse detection by the Payment Integrity ... to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive… more
- Granite State Physical Therapy Hooksett PLLC (Gilford, NH)
- …Control, Blood borne Pathogens, Safety, Hazard and Hazard Communication Training and Fraud and Abuse training is current.Annual TB questionnaire and any ... and instruction requirements as well as any other standards that govern healthcare services provision Assist with and/or carry out routine cleaning, maintenance… more
- Pace of Southwest Michigan (St. Joseph, MI)
- …in the state of Michigan; CPR certification. To improve efficiency and reduce fraud and abuse , a National Provider Identifier (NPI) number is required.Special ... growing TEAM!PACE (Program of All-Inclusive Care for the Elderly) is a unique healthcare solution for seniors who struggle with health issues that may jeopardize… more
- Commonwealth Care Alliance (Boston, MA)
- …document review, witness interviews and data analysis to identify, evaluate and measure potential healthcare fraud and abuse to determine valid cases for ... Associate Investigator works with a growing team conducting and managing Health Care Fraud , Waste and Abuse investigation and prevention activities under the… more
- Daiichi Sankyo Inc. (Basking Ridge, NJ)
- …knowledge of laws and regulations applicable to global pharmaceutical companies, including, US healthcare fraud and abuse laws, anti-corruption laws, such as ... Practices Act and the UK Bribery Act (2010), US fraud and abuse and false claims laws,...claims laws, and relevant industry codes on interactions with healthcare professionals required - 1 or More Years Prior… more
- BlueCross BlueShield of North Carolina (NC)
- …Medicare Part D experience preferred. + Experience in identifying and mitigating pharmacy or healthcare fraud , waste, and abuse . + Strong analytical and ... experience in Medicare Part D and compliance management. Pharmacy Fraud , Waste, and Abuse Initiative: Collaborate with...and abuse . This initiative demands expertise in fraud detection and prevention within healthcare or… more
- New York State Civil Service (Hauppauge, NY)
- …detectives, and analysts to identify and prosecute financial fraud in the healthcare industry and abuse and neglect of residents in healthcare ... Attorney General, Office of the Title Associate Attorney: Investigate/Prosecute Medicaid Fraud (3696) Occupational Category Legal Salary Grade NS Bargaining Unit M/C… more
- Sanofi Group (Cambridge, MA)
- …legal counsel on matters relevant to the pharmaceutical industry, including compliance with Healthcare Fraud and Abuse matters, FDA regulations governing the ... Care** **Location: Cambridge, MA** **About the Job:** We are an innovative global healthcare company with one purpose: to chase the miracles of science to improve… more
- Conduent (Fort Myers, FL)
- …of new audit/review methodologies to identify overpayments and underpayments to providers. Detecting healthcare fraud , waste, and abuse . + Preparing written ... to visit Medical Central Billing Offices. + Have experience with **medical claims, healthcare administration, or hospital billing** . + Have ability to use deductive… more
- US Bank (Fargo, ND)
- …**_Position Highlights_** + Responsible for managing, monitoring, and coordinating first party fraud /credit abuse risk projects for consumer and business credit ... Operations leadership team. + Tracks weekly RPS first party fraud and bustout activity, working with RPS Risk First...may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional… more
- Providence (OR)
- …related to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan staff, vendors and contracted ... provider, facility or health insurance company + 2+ years fraud and abuse audit experience at a...health care fraud investigation, such as Accredited Healthcare Fraud Investigator (AHFI), Certification as an… more
- House of Blues (CA)
- …ecosystem. This leadership position not only demands technical excellence but also well versed in fraud and abuse industry trends. WHAT THIS ROLE WILL DO + Lead ... in developing Data Platforms and/or Machine Learning models. + Experience working in Abuse Prevention, Trust & Safety, Cybersecurity, and/or Fraud required +… more
- Live Nation (CA)
- …to the Chief Information Security and Privacy Officer, you will lead the Global Abuse Prevention team, joining as a senior leader in Corporate ISP. Live Nation ... Entertainment's abuse prevention program aims to protect fan, client, and...and other abusive online behaviors. + Separate to the Fraud team, that also reports to the Chief Information… more
- House of Blues (CA)
- …Platforms and/or Machine Learning models is a plus. + Prior experience in Abuse Prevention, Trust & Safety, Cybersecurity, and/or Fraud prevention is ... live. THE ROLE Reporting to the Senior Director of Abuse Prevention, the Manager of Abuse Prevention...stars who keep the live experience going. Generous vacation, healthcare , and retirement benefits are just some of the… more
- Tufts Medicine (Burlington, MA)
- …(3) years of management experience. 3. Extensive experience and understanding of applicable healthcare laws, including fraud and abuse statutes and ... We're saving lives, building careers, and reimagining healthcare . We can't wait to grow alongside you. **Job Profile Summary** This role focuses on ensuring the… more
- Amazon (Austin, TX)
- …in high energy environments to help us continue to solve security challenges and combat fraud and abuse at massive scale. In this role, you will leverage your ... in a wide variety of areas including cloud, devices, retail, entertainment, healthcare , operations, and physical stores. *Inclusive Team Culture* In Amazon Security,… more
- Danaher Corporation (Austin, TX)
- …/ IVD industry. + Experience in the medical device industry. + Experience with healthcare regulation, including: fraud and abuse (eg, anti-kickback); FDA for ... medical devices; data use and privacy (eg, HIPAA, GDPR); and anti-corruption (eg, FCPA). At Leica Biosystems we believe in designing a better, more sustainable workforce. We recognize the benefits of flexible, remote working arrangements for eligible roles and… more
- Atlantic Health System (Morristown, NJ)
- …Medicare and Medicaid, and federal and state healthcare regulatory issues, including fraud and abuse , the Stark Law, the Anti - Kickback Statute, and ... monitoring of regulatory developments, and legal research on regulatory issues, including fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid… more
