- MultiPlan (Atlanta, GA)
- …Utilize analytics and data mining and coordination of benefits techniques to client paid claims data.3. Evaluate medical claims for coding and pricing errors ... using accurate HCPCS, ICD-10, and CPT codes. 4. Lookup and review medical claims in payer system to determine methods of payment and validate savings identified.… more
- CornerStone Staffing (Carmel, IN)
- Join CornerStone Staffing as we seek a skilled Claims Investigator to support our client in the insurance sector. In this role, you will leverage your ... evaluations. Apply today to make a difference in the industry! Job Title: Claims Investigator Location: Carmel, IN Pay: $17 Schedule: Mon - Fri 8:30AM-5:00PM… more
- Allied Universal (Billings, MT)
- …programs, and exclusive perks. Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims Investigators validate the ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is… more
- Allied Universal (Durango, CO)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims / SIU Specialists investigate ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....+ Ability to be properly licensed as a Private Investigator as required by the state where work Is… more
- AIG (Atlanta, GA)
- …reimagining the way we help customers to manage risk. Join us as a Principal Claims Investigator to play your part in that transformation. It's an opportunity to ... efficiency. How you will create an impact The Principal Claims Investigator is responsible for all aspects...covering all lines of business involving claimants, brokers, lawyers, medical providers, etc., to support the Claims … more
- WMCHealth (Valhalla, NY)
- Claims Investigator Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Professional/Non-Clinical Department: Risk Management- WMC ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/26645) Internal Applicant link Job Details: Job Summary: The Claims Investigator is responsible for the management… more
- State of Indiana (Fort Wayne, IN)
- Claims Investigator Date Posted: Sep 10, 2024 Requisition ID: 449354 Location: Fort Wayne, IN, US, 46774 Work for Indiana Begin a fulfilling career with the ... to thrive in a changing economy. Role Overview: A Claims Investigator ("CI") is part of the...package for full-time employees which includes: + Three (3) medical plan options (including RX coverage) as well as… more
- Robert Half Office Team (Carmel, IN)
- Description We are seeking a Claims Investigator to join our team in the Financial Services industry, located in CARMEL, Indiana, United States. In this role, ... you will be responsible for investigating claims , gathering and documenting information, interacting with external insurance carriers, and handling customer… more
- Command Investigations (Los Angeles, CA)
- …for hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, ... include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Extensive performance bonus program… more
- Command Investigations (Orlando, FL)
- …for hire. Visit our website and find out why at www.GoCommand.com. The Claims /Field Investigator should demonstrate proficiency in the following areas: + Writing ... Degree in Criminal Justice or similar + Bilingual candidates Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Dynamic and fast paced work… more
- Medical Mutual of Ohio (Rossford, OH)
- …functions/calculations ie: addition, subtraction, percentages, fractions. . Knowledge of medical terminology and coding. **Senior Financial Investigator ** . ... **_Note, requires 2 days per week in-office in Rossford, Ohio._** Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …and obtain medical records/ and other relevant documentation. The Senior Investigator will also act as subject matter expert in researching and communicating ... **Responsibilities** The Sr. Fraud Investigator SIU (Special Investigations Unit) assists in the...experience Preferred: N/A **Experience** Required: 4+ years' experience in claims examination, adjusting, fraud detection, or investigations in a… more
- Commonwealth Care Alliance (Boston, MA)
- …reports. **What You'll Be Doing:** **Essential Duties & Responsibilities:** + Conduct prospective medical record review of claims as part of a prepayment review ... Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of...recommendations. + Review and analyze internal and external referrals, claims and associated medical records to identify… more
- Kaleida Health (Buffalo, NY)
- …or violations of the company's policies including but not limited to claims of discrimination, harassment, bullying ,workplace violence, work performance concerns or ... Vision and Values of Kaleida Health. The Sr. HR Investigator will be responsible for reviewing complaints and planning,...Labor & Employment Counsel to investigate third party agency claims such as but not limited to EEOC, NYS… more
- State of Georgia (Fulton County, GA)
- …AND two (2) years of clinical experience AND one (1) year experience working with medical claims . Preference will be given to applicants who hold a Bachelor's of ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot...experience; additional years of experience in the analysis of medical claims and/or claims data;… more
- MyFlorida (Fort Lauderdale, FL)
- OPS MEDICAL MALPRACTICE INVESTIGATOR - 64801506 Date: Sep 15, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 822649 Agency: Department of Health Working Title: OPS MEDICAL MALPRACTICE INVESTIGATOR - 64801506 Pay Plan: Temp Position Number:… more
- Elevance Health (Indianapolis, IN)
- …Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical -expense spending. The **Senior Investigator ** is responsible for the ... **Senior Investigator ( Investigator Sr)** _Location: This position...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and...may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to… more
- Elevance Health (Nashville, TN)
- …Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical -expense spending. ** Investigator II** is responsible for the ... ** Investigator II - Carelon Payment Integrity** **Location** :...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- US Agency for International Development (Washington, DC)
- …and Millennium Challenge Corporation (MCC). Responsibilities As a GS-13 Criminal Investigator you will: Conduct complex and large-scale criminal, civil, and ... Applicants may make changes to applications to ensure experience is current. MEDICAL REQUIREMENTS: The duties of this position require moderate to arduous physical… more
