- CVS Health (Tallahassee, FL)
- …plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing ... Aetna business. + Keep current with new and emerging fraud , waste, and abuse schemes and trends through training...3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and… more
- CVS Health (Tallahassee, FL)
- …medical codes for diagnoses as documented for physicians and other qualified healthcare providers in the office and/or facility setting. + Thorough knowledge of ... opportunities for providers, vendors and peers. + Expertise in medical documentation, fraud , abuse and penalties for documentation and coding violations based on… more
- CVS Health (Tallahassee, FL)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud… more
- Zelis (St. Petersburg, FL)
- …So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more ... top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across… more