- Molina Healthcare (Cedar Rapids, IA)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- CVS Health (Des Moines, IA)
- …this role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + ... Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of… more
- Molina Healthcare (Sioux City, IA)
- …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... The position must have the ability to determine correct coding, documentation, potential fraud , abuse , and over utilization by providers and recipients. The… more
- Molina Healthcare (IA)
- …Areas of exposure may include: + Economics/Finance + Data Analysis / Science + Fraud , Waste, and Abuse (FWA) + Other data intensive areas **Preferred ... **JOB DESCRIPTION** **Job Summary** The Molina Healthcare Internship Program shares an objective to create...aim to be professionals and future leaders in the healthcare business profession. Interns are assigned special projects and… more
- Molina Healthcare (Iowa City, IA)
- …coordinating data extractions, gathering requirements, supporting payment integrity teams, primarily fraud , waste and abuse . + Experience working on SQL, ... PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required Education** Associate degree or… more
- Highmark Health (Des Moines, IA)
- …Analytics will work closely with Senior Data Scientists to support Highmark's Fraud , Waste, and Abuse identification efforts. Daily responsibilities will involve ... the in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect...the business. - Collaborate with senior team members on Fraud , Waste, and Abuse identification initiatives to… more
- UnityPoint Health (Cedar Rapids, IA)
- …for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions or concerns regarding compliance ... for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions or concerns regarding compliance… more
- UnityPoint Health (Cedar Rapids, IA)
- …for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions or concerns regarding compliance ... for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions or concerns regarding compliance… more
- CVS Health (Des Moines, IA)
- …self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect ... Aetna business. + Keep current with new and emerging fraud , waste, and abuse schemes and trends...3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and… more
- CVS Health (Des Moines, IA)
- …3-5 years. + Strong analytical and investigative skills, with experience in healthcare fraud detection. + Proficiency in interpreting claims data, medical ... plays a pivotal role in safeguarding the organization against fraud , waste, abuse (FWA), and compliance violations. This position is embedded within… more