- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by ... GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years...5+ years of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall ... criminal justice or related field; or employment as an investigator in the SIU on or before...and supporting systems. (BREADTH). + Expertise in complex clinical coding /reviewing assignments, difficult investigations and highly visible… more
- MVP Health Care (Rochester, NY)
- …York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + Maintain ... improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more