- CVS Health (Atlanta, GA)
- …accreditation from the National Health Care Anti-Fraud Association (AHFI). - Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA) - Knowledge ... all with heart, each and every day. **Position Summary** - Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... criminal justice or related field; or employment as an investigator in the SIU on or before...and supporting systems. (BREADTH). + Expertise in complex clinical coding /reviewing assignments, difficult investigations and highly visible… more
- MVP Health Care (Tarrytown, NY)
- …York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + Maintain ... improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more
- Point32Health (Canton, MA)
- …an essential team member of the Special Investigation Unit (" SIU ") responsible for leading complex provider investigations related to fraud, waste, and ... **Job Summary** The Investigator I is...for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the Manager, FWA Prepayment… more