- CVS Health (Hartford, CT)
- …deliver solutions to make health care more personal, convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our team of ... Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation , and prevention… more
- Humana (Hartford, CT)
- …enforcement authorities to coordinate investigations and supervises the activities of the Special Investigations Unit (SIU) to ensure accurate and timely ... caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of...field or equivalent. 7+ years of related compliance and/or special investigation experience in managed care or… more
- Elevance Health (Wallingford, CT)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of ... 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 (Hartford, CT)
- …on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel. + Investigates each claim ... Control, Salvage and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings. +… more
- Hartford HealthCare (Farmington, CT)
- …cycle industry standards. Demonstrates effective and efficient work operation of the unit and assigning work according to business needs and collecting data to ... future denial. . Coordinates clinical appeals process and participates in compliance investigations as needed. *Education* . Identifies root causes and assists in… more
- CVS Health (Hartford, CT)
- …The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding ... SIU schemes. + Act as management back-up and supports the team when the manager is out of the office. **Required Qualifications:** + AAPC Coding certification + 3+… more
- CDM Smith (Hartford, CT)
- **39982BR** **Requisition ID:** 39982BR **Business Unit :** TSU **Job Description:** We are looking for a dedicated and experienced Process Mechanical Environmental ... design activities in client-facing role, with ability to function as Task Manager or Project Technical Leader. Contributes to firm's Technical Knowledge Management… more
- CDM Smith (Hartford, CT)
- **38698BR** **Requisition ID:** 38698BR **Business Unit :** TSU **Job Description:** Under direct supervision, performs basic engineering tasks in support of the ... white papers and technical design documentation of new or special case designs, studies, etc. Submits technical papers and...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- CDM Smith (Hartford, CT)
- **39874BR** **Requisition ID:** 39874BR **Business Unit :** TSU **Job Description:** Under direct supervision, develops large scale projects such as highways, ... white papers and technical design documentation of new or special case designs, studies, etc. Submits technical papers and...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- CDM Smith (Hartford, CT)
- **38747BR** **Requisition ID:** 38747BR **Business Unit :** TSU **Job Description:** At CDM Smith, we are committed to tackling the complex challenges facing our ... white papers and technical design documentation of new or special case designs, studies, etc.. Collaborates with sales staff...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more