- Elevance Health (Mason, OH)
- …responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse . **How you will make an impact:** + Examines ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. +...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …development of compliance internal monitors and audit protocols and the prevention of fraud , waste and abuse . + Develops compliance monitors and audit protocols ... of claims audit or investigation. + Maintains awareness of fraud , waste and abuse laws and regulations...and regulations and current industry changes that may impact healthcare revenue cycle services domestic and international through personal… more
- Cardinal Health (Columbus, OH)
- …firm or in-house healthcare experience preferred, including commercial transactions and fraud and abuse compliance expertise + Experience working with Group ... to pharmaceutical distribution and services and group purchasing organizations, specifically AKS/ Fraud & Abuse + Identify opportunities for process improvements… more
- Cardinal Health (Columbus, OH)
- …patients and prescribers and by federal and state government programs, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act, Civil Monetary ... Health is seeking a driven and skilled attorney with expertise in healthcare regulatory compliance, including third party billing and reimbursement. The Assistant… more
- Cardinal Health (Columbus, OH)
- …firm or in-house healthcare experience preferred, including commercial transactions and fraud and abuse compliance expertise + Experience working with Group ... and Compliance teams + Demonstrate knowledge of general commercial and healthcare law; specifically, regulations related to pharmaceutical distribution and services… more
- Walgreens (Canal Winchester, OH)
- …with policies andprocedures (eg, HIPAA guidelines/regulations, insurance, and fraud abuse guidelines, requiredproductivity levels, timeliness expectations, ... channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice… more
- CVS Health (Columbus, OH)
- …to coding questions, state and federal policies, and identify potential billing errors, abuse , and fraud . + Identify opportunities for savings related to ... through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers. The CPC Manager will be responsible for guiding the… more