• Investigator, SIU (Remote)

    Molina Healthcare (Albany, NY)
    …Medicare programs as well as Marketplace. + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems. + Understanding ... waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and...Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you… more
    Molina Healthcare (03/21/25)
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  • Payment Analyst

    City of New York (New York, NY)
    …of Health and Mental Hygiene (DOHMH) and the Office of the Chief Medical Examiner . The unit processes over 2,000 invoices a month which are received ... Duties and Responsibilities: - Perform internal audits, examination of expenditure claims to determine eligibility of costs reported. - Prepare claim verification… more
    City of New York (05/14/25)
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  • Forensic Auditor: Investigate Healthcare Fraud

    New York State Civil Service (Syracuse, NY)
    …industry and medical coding concepts (CPT, ICD-9/10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the position ... to conduct complex, long-term healthcare fraud investigations.The Medicaid program provides health coverage to millions of New Yorkers, including low-income persons,… more
    New York State Civil Service (05/17/25)
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