- State of Indiana (Indianapolis, IN)
- …and their families from loss or harm. Consumers may need assistance with certain claim situations or just help in understanding how their policies work. Our other ... with the insurer and other regulators + Correspond with insurance company executives, internal department staff, and other state, federal, or international… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …analytic problems through communication and collaboration. + Knowledge of BCBSMA claims processing system is preferred. + Proficient analytical and report ... data and identify potential fraud risks. + Working knowledge of health insurance claims coding, including CPT, HCPCS, ICD-10, and DRG coding. This is an essential… more
- LA Care Health Plan (Los Angeles, CA)
- …data by delegates on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements. Manages complex ... including recommendations and corrective action plans requirements. Maintains related company 's policies and procedures ensuring they are current. Proactively… more
- Highmark Health (Montgomery, AL)
- ** Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for developing and maintaining an anti-fraud program which includes ... **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC)… more
- Option Care Health (Bannockburn, IL)
- …the infusion care experience for patients, customers and team members. Join a company that is taking action to develop an inclusive, respectful, engaging and ... to analyze large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and to identify… more
- Johns Hopkins University (Las Vegas, NV)
- …+ Perform urine drug screening and breath alcohol testing in accordance with company protocol. + Provide on-site assessments for acute and chronic illnesses, such as ... to workers' compensation or disability, as necessary in adherence with company protocols. + Coordinate annual seasonal influenza vaccination program. + Coordinate,… more
- STG International (Rockville, MD)
- …Program provides critical support in evaluating and managing workers' compensation claims , reasonable accommodations, Family Medical Leave Act (FMLA) requests, and ... component. May require ACLS training. May be required to have the Medical Examiner 's Certificate for Certified Driver License exams, Proof of annual TB testing,… more
- Johns Hopkins University (Chicago, IL)
- …Perform urine drug screening and breath alcohol testing in accordance with company protocol. + Provide onsite assessment for strep pharyngitis, UTI, influenza, ... to workers' compensation or disability, as necessary in adherence with company protocols. + Coordinate annual seasonal influenza vaccination program. + Coordinate… more
- Johns Hopkins University (Chicago, IL)
- …Perform urine drug screening and breath alcohol testing in accordance with company protocol. + Provide onsite assessment for strep pharyngitis, UTI, influenza, ... to workers' compensation or disability, as necessary in adherence with company protocols. + Coordinate annual seasonal influenza vaccination program. + Coordinate… more
- New York State Civil Service (Pearl River, NY)
- …companies for defrauding Medicaid, and conviction and sentencing of taxi company owners for stealing millions from Medicaid. Minimum Qualifications Qualifications:* ... investigation of alleged fraud.* Designation as a Certified Fraud Examiner .* Experience with statistical sampling and/or advanced statistical training.* Knowledge… more