- Elevance Health (Mason, OH)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Location Hybrid 1** : This role requires associates to...of proprietary data and claim systems for review of facility, professional and… more
- Elevance Health (Columbus, OH)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- Elevance Health (Mason, OH)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that… more
- CVS Health (Columbus, OH)
- …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more