- CVS Health (Columbus, OH)
- …years of clinical experience required + 2+ years of experience as a Registered Nurse + Must have active, current and unrestricted RN licensure in state of residence ... + 2+ years of experience using Microsoft Office products, including Outlook and Excel, and previous experience using Internet Explorer and Google Chrome to effectively utilize review resources and conduct reviews. + Must be able to work Monday through Friday… more
- CVS Health (Columbus, OH)
- …innovate and deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our ... responsible for overseeing and managing coding reviews for fraud detection, investigation , and prevention efforts to safeguard the organization's resources and… more
- Elevance Health (Mason, OH)
- ** Nurse and CPC - Clinical Fraud Investigator II -...aid in investigations . + Collaborates with the Special Investigation Unit and other internal ... analysis and clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance… more
- Travelers Insurance Company (Independence, OH)
- …handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, negotiation and resolution) including maintaining full ... Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions. + Coverage Analysis : + Reviews and… more
- Brookdale Senior Living (Westlake, OH)
- …Details Join the Brookdale Westlake Village team today! + We are a 350 unit continuing care retirement community, or CCRC, which means we have Independent Living, ... and directs orientation programs for skilled nursing personnel. Conducts regular or special in-services for staff to ensure they remain current on new procedures.… more
- Brookdale Senior Living (Westlake, OH)
- …Details Join the Brookdale Westlake Village team today! + We are a 350 unit continuing care retirement community, or CCRC, which means we have Independent Living, ... and directs orientation programs for skilled nursing personnel. Conducts regular or special in-services for staff to ensure they remain current on new procedures.… more