- Zurich NA (Providence, RI)
- Claims Fraud and Investigations Manager 117871 Zurich North America is seeking a Claims Fraud and Investigations Manager to support our ... role and can reside anywhere in the United States. The Claims Fraud and Investigations Manager is responsible for managing the daily activities of the … more
- CVS Health (Woonsocket, RI)
- … Unit is seeking a Sr. Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing ... and external stakeholders and ensuring compliance with regulatory requirements. The Senior Manager develops strategies to mitigate fraud risks, analyzes complex… more
- Elevance Health (Smithfield, RI)
- …in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify ... **Clinical Fraud Investigator II - SIU Fraud ...prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new… more
- Elevance Health (Smithfield, RI)
- …for identifying issues and/or entities that may pose potential risks associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more