- Kelsey-Seybold Clinic (Pearland, TX)
- …interviews and obtain medical records/ and other relevant documentation. The Senior Investigator will also act as subject matter expert in researching ... **Responsibilities** The Sr . Fraud Investigator SIU (Special Investigations...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)
- **Why This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr . Associate is an integral part of the Fraud, Waste & Abuse (FWA) ... other CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim...Be Doing:** **Essential Duties & Responsibilities:** + Conduct prospective medical record review of claims as part… more
- Kaleida Health (Buffalo, NY)
- …and consistent with the Mission, Vision and Values of Kaleida Health. The Sr . HR Investigator will be responsible for reviewing complaints and planning, ... to conduct investigations in a thorough and objective manner to provide recommendations. The Sr . HR Investigator will partner with the VP Labor & Employment… more
- Elevance Health (Indianapolis, IN)
- ** Senior Investigator ( Investigator Sr )** _Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 ... Integrity, is determined to recover, eliminate, and prevent unnecessary medical -expense spending. The ** Senior Investigator **...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- EFI Global (Sacramento, CA)
- …buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims . + Ensures that assigned cases are investigated and...ethical manner. + May provide investigative guidance to Fire Investigator team members. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- EFI Global (Cincinnati, OH)
- …or Cincinnati, OH area.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported back to the requesting party in adherence to best practices.… more
- HCA Healthcare (Lone Tree, CO)
- …leaders. * Hands-on experience working with/analyzing diverse data assets: EMR, medical claims , registry, publicly available administrative datasets (population ... and integrity. We care like family! Jump-start your career as a Research Outcomes Investigator Jr today with Sky Ridge Medical Center. **Benefits** Sky Ridge … more
- Centene Corporation (Tallahassee, FL)
- … claim analysis, or fraud investigation experience. Knowledge of Microsoft Applications medical coding, claims processing, and data mining preferred. **Please ... and abuse activity. Assist in planning, organizing, and executing special claims investigations or audits that identify, evaluate and measure potential healthcare… more
- Providence (OR)
- …manage a workload with multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing and performing ... people, we must empower them._** **Providence Health Plan is calling an Investigator , Special Investigation Unit who will:** + Support timely completion of… more
- Elevance Health (Cary, NC)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Investigator II** is responsible for the ... ** Investigator II** **Supporting the Payment Integrity line of...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Elevance Health (Columbus, OH)
- ** Investigator II** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of Columbus, Ohio; ... Mason, Ohio; and Indianapolis, Indiana. The ** INVESTIGATOR II** is responsible for the identification, investigation and...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- DHS Headquarters (Kansas City, MO)
- …Incumbent must successfully complete the Federal Law Enforcement Training Center's Criminal Investigator Training Program, or its equivalent. Medical : The person ... criminal investigative, law enforcement, and physical security programs. Liaising with senior managers and Regional Directors to develop and recommend national… more
- Abbott (St. Paul, MN)
- …spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000 colleagues ... serve people in more than 160 countries. ** Senior Principal Clinical Scientist** **Working at Abbott** At Abbott,...can grow the career you dream of. . Free medical coverage for employees* via the Health Investment Plan… more
- The Mount Sinai Health System (New York, NY)
- …+ HS/GED; Associates Degree or higher is preferred. + 5+ years experience in medical billing or health claims , with experience in current electronic billing ... **JOB DESCRIPTION** The Senior Billing Coordinator and Analyst is an experienced...and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- The Mount Sinai Health System (New York, NY)
- …of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The ... DESCRIPTION** Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner....Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- The Mount Sinai Health System (New York, NY)
- …**QUALIFICATIONS** + HS/GED; Associates Degree is preferred + 3+ years of experience in medical billing or health claims , with experience in billing systems in a ... **JOB DESCRIPTION** ** Senior Biller-Oncology Billing Corporate East 42nd Street Full-Time...and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- The Mount Sinai Health System (New York, NY)
- …high school diploma/GED plus 3 years of relevant experience + 3 years experience in medical billing or health claims , with experience in IDX billing systems in a ... **JOB DESCRIPTION** The Senior Billing Coordinator (Generalist) is responsible for multiple...and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- The Mount Sinai Health System (New York, NY)
- …performing analysis to inform business decisions. * Analyze issues using enrollment, claims , clinical/EHR, medical management, financial and other corporate data ... economics analyses, including utilization and unit cost analyses of medical and pharmacy claims . ? At least...and in the 99th percentile in research dollars per investigator according to the Association of American Medical… more
- The Mount Sinai Health System (New York, NY)
- …of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The ... Diversity** Ground breaking science. Advancing medicine. Healing made personal. **Job Title: Senior Clinical Risk Manager - Mount Sinai West** **Job Summary:** The … more
- The Mount Sinai Health System (New York, NY)
- …of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The ... **JOB DESCRIPTION** Senior Clinical Risk Manager The Senior ...to develop educational plans for instructing staff about the medical center's activities and the daily administration of its… more