- Elevance Health (Tampa, FL)
- …to Legal on associate relations matters. + Regularly partners with Ethics and Compliance on crossover investigations . + Partners with AR leadership and HRBP ... for associate relations issues including but not limited to: investigations , agency charges (EEO, DOL), employment litigation, associate complaints, performance… more
- USAA (Tampa, FL)
- …records and medical claims, and provide expert advice. Conducts review of complex healthcare fraud investigations and providing claims support + Medical Coding ... Regulatory Experience: Experience working with Medicare state and federal regulations. + Investigation Skills: Ability to conduct complex healthcare fraud … more
- Elevance Health (Tampa, FL)
- …+ Researches new healthcare related questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal ... analysis and clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance… more
- Highmark Health (Tallahassee, FL)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and… more
- Langan Engineering, Environmental, Surveying and Landscape… (Fort Lauderdale, FL)
- …and compliance with regulatory agency permits to support site investigation and remediation; + Review and interpret environmental, geological, and historical ... for major developers, renewable energy producers, energy companies, corporations, healthcare systems, colleges/universities, and large infrastructure programs throughout the… more
- MyFlorida (Stuart, FL)
- …and Health Management System (HMS) and uploads all documents in HMS. Determines compliance with treatment plan and reports any problems to the Nurse Case Manager ... as needed or as requested by NCM and Supervisor. Assists in TB investigations and contact tracing. Provides patient and family with education on Tuberculosis and… more
- CVS Health (Tallahassee, FL)
- …a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role is ideal ... skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,...waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job… more
- Langan Engineering, Environmental, Surveying and Landscape… (Miami, FL)
- …and compliance with regulatory agency permits to support site investigation and remediation; + Review and interpret environmental, geological, and historical ... for major developers, renewable energy producers, energy companies, corporations, healthcare systems, colleges/universities, and large infrastructure programs throughout the… more
- Elevance Health (Tampa, FL)
- …+ Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and ... you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies...changes in laws/regulations. + Collaborates with the Special Investigation Unit and other internal areas on matters of… more
- BPC Plasma, Inc. (Fort Myers, FL)
- Would you like to join an international team working to improve the future of healthcare ? Do you want to enhance the lives of millions of people? Grifols is a global ... healthcare company that since 1909 has been working to...level of quality inspection and control -- ensures center compliance with quality standards and regulations. * Collaborates with… more