- New York State Civil Service (New York, NY)
- …investigation of alleged fraud.* Designation as a Certified Fraud Examiner .* Experience with statistical sampling and/or advanced statistical training.* Knowledge ... medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data.* A CPA is not required; but the position qualifies for CPA… more
- National Health Care Associates (West Hartford, CT)
- …issues/resolution. + **_Administration:_** + Manage WC: Cinch form submission, partner with claims examiner , OSHA log recordkeeping, attend safety meetings, and ... input during quarterly WC status calls. + Leave and Disability Management: LOA, FMLA, STD coordination of all paperwork and tracking. + Accountable for transactional items: filing, verifications, references, PAFs (status changes), monthly licensure… more
- Johns Hopkins University (Piscataway, NJ)
- …health and wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. + Provide crisis ... in Occupational Medicine, Workers' Compensation, and DOT exams + DOT Medical Examiner preferred. + Certified Urine Drug Screen Collector preferred. + Certified… more
- Lawrence General Hospital (Lawrence, MA)
- …including patient request, attorney request, court orders, subpoenas, and Medical Examiner request. + Reviews EMS daily logs for completeness, identifies missing ... needed to assist in obtaining missing information to facilitate the billing of claims + Oversees preparation for meetings by completing agendas, taking minutes and… more
- Point32Health (Canton, MA)
- …involving existing and upcoming FWA schemes. + Handling substantial prepayment claims including extensive administrative tasks, review of medical records, and ... Certification and Licensure + Certified Professional Coder ("CPC"); Certified Fraud Examiner ("CFE") designation a plus. Education + Required (minimum): Bachelor's… more
- Highmark Health (Pittsburgh, PA)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
- Idaho Division of Human Resources (Boise, ID)
- …financial crimes or white-collar investigations. + Experience analyzing financial records, claims data, or medical billing. + Proficiency in writing affidavits, ... and abuse. + Candidates with certifications such as Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), or Certified Professional Medical Auditors… more
- Option Care Health (Bannockburn, IL)
- …to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and to identify ... in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or similar certification preferred. + Direct experience in home… more