- Elevance Health (Rancho Cordova, CA)
- …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 (Los Angeles, CA)
- ** 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
- Travelers Insurance Company (Diamond Bar, CA)
- …identify risk and combat fraudulent practices at scale. As an SIU Specialized Investigator , you will lead complex, multi- claim investigations with regional and ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...salary range provided for this position is a nationwide market range and represents a broad range of salaries… more
- Elevance Health (Costa Mesa, CA)
- **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
- Highmark Health (Sacramento, CA)
- …Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment ... methodology, claims processing systems and coding and billing proficiency +...and expected contributions, as well as internal peer equity, market , and business considerations. The displayed salary range does… more
- University of Southern California (Los Angeles, CA)
- …lead programmer and technical specialist on research projects that use administrative healthcare claims data. SAS is required. The programmer is an integral part of ... the research team and works closely with the principal investigator and a multidisciplinary research team. The key role of the programmer is to develop a plan to… more