- KPH Healthcare Services, Inc. (Syracuse, NY)
- …drug screening test **Required Training:** + HIPPA Privacy Course + HIPPA Security Course + Fraud , Waste, and Abuse Course + MethGuard Course + HIPPA Privacy CE ... Mastery Exam + HIPPA Security CE Mastery Exam + Fraud , Waste, and Abuse CE Mastery Exam...such as relevant skills, years of experience,and education. **KPH Healthcare Services, Inc. is a multistate organization and abides… more
- Molina Healthcare (Yonkers, NY)
- …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 (Syracuse, NY)
- …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
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …on the specific position **Required Training:** + HIPAA Privacy & Security Course + Fraud , Waste and Abuse Course **Job Skill Requirements:** + Business to ... business experience required + Superior communication skills, both verbal and written + Superior organizational skills + Ability to multi-task and prioritize + Coordinate and lead others in process improvement and change + Flexibility and ability to work under… more
- Highmark Health (Albany, NY)
- …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
- University of Rochester (Brighton, NY)
- …and assisted living communities. This includes, but is not limited to fraud and abuse , billing compliance, corporate transactions, physician employment and ... Counsel for Health Sciences, researches, analyzes, and provides regulatory compliance advice on the Fraud and Abuse + Laws, including, but not limited to, the… more
- CVS Health (Albany, NY)
- …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
- Stryker (New York, NY)
- …sale and marketing of medical devices/technologies including matters related to anti-trust, fraud and abuse , HIPAA, and anti-kickback (including applicable safe ... work experience required + 3+ years applicable experience required **Preferred** + 2+ fraud and abuse , anti-kickback experience is highly desirable + Direct work… more
- CVS Health (Albany, NY)
- …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
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more