- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement,… more
- Goodwill of the Finger Lakes (Syracuse, NY)
- …+ Ability to work independently and under pressure ESSENTIAL DUTIES AND RESPONSIBILITIES 1 . Investigations (50%) + Maintain compliance with the law and company ... SUMMARY: The Risk Management Investigator is responsible for protecting company assets and...protecting company assets and promoting safety through investigation, enforcement, audit , and assessment of company operations. This role requires… more
- Highmark Health (Albany, NY)
- …for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into ... Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated… more
- DoorDash (New York, NY)
- …robust safeguards and unwavering vigilance. About the Role The Insider Threat Investigator will be a foundational member of the Internal Investigations team, ... has been reviewed by an independent auditor. Results of the audit may be viewed here: Covey (https://getcovey.com/nyc-local-law-144) Compensation The successful… more
- City of New York (New York, NY)
- …collects monies when the balances exceed the allowable levels. C&C is recruiting for ( 1 ) one Associate Fraud Investigator II to function as a Group Supervisor, ... for even and timely distribution to the investigative staff. Audit assignments to subordinate staff. - Review and examine...to 5 Work Location: 375 Pearl Street ASSOCIATE FRAUD INVESTIGATOR ( - 31118 Qualifications 1 . A… more
- Mount Sinai Health System (New York, NY)
- …Assistant II plays a vital role in supporting clinical research compliance by managing and maintaining electronic regulatory binders. This position ensures ... that all regulatory documentation is accurate, current, and audit -ready, while collaborating closely with regulatory affairs teams to uphold institutional and… more
- Mount Sinai Health System (New York, NY)
- …payment. This position plays a key role in ensuring the financial health and compliance of the organization and bridges the gap between clinical care and medical ... requires a unique blend of clinical expertise and financial acumen to ensure compliance with healthcare regulations and collaborate with staff to resolve issues and… more
- Mount Sinai Health System (New York, NY)
- …communicated and coordinated with the performing departments **Charge Capture Auditing & Compliance :** + Audit charge capture for inpatient, outpatient, clinic, ... CDM Chargemaster with strong medical coding expertise to support the maintenance, compliance , and optimization of the hospital Charge Description Master (CDM). The… more
- Mount Sinai Health System (New York, NY)
- …includes focusing on the healthcare revenue cycle, patient billing, and maintaining compliance with US GAAP and ASC 606 standards. Key responsibilities include ... in a large academic healthcare setting. + Possess prior Big 4 audit background and/or experience in high-growth environments. + Build, maintain, and refine… more
- Mount Sinai Health System (New York, NY)
- …high-performing team as measured through the achievement of benchmark process outcomes, audit and compliance results, financial goals, and employee satisfaction. ... implement policies and procedures that promote efficiency, data integrity, and regulatory compliance (eg NYS, CMS). + Monitor key performance indicators (KPI) such… more