• Clinical Reimbursement Manager; HSO Drg…

    Mount Sinai Health System (New York, NY)
    …of the beneficiary, as coded and reported by the hospital on its claim , matches both the attending physician's description and the information contained in the ... regulatory requirements. The CRM works in conjunction with the Associate Director and Director of DRG Validation to help...and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges.… more
    Mount Sinai Health System (07/17/25)
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  • Sr. Fraud Data Analyst

    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
    Blue Cross Blue Shield of Massachusetts (09/12/25)
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  • Research Finance Consultant

    OhioHealth (Columbus, OH)
    …team members for clinical trial budgets by industry as well as investigator initiated clinical research. Critically evaluates research protocols to assess resource ... and revenue cycle. Work with Patient Financial Services to manage the denied claims list for any potential errors and resubmissions. Facilitate CMS compliance and… more
    OhioHealth (09/05/25)
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  • Special Investigation Unit Lead Review Analyst…

    CVS Health (Harrisburg, PA)
    …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
    CVS Health (08/20/25)
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  • Law Enforcement Auditor

    The County of Los Angeles (Los Angeles, CA)
    …education completed from an accredited college or university? + Not Applicable + Associate 's degree + Bachelor's degree + Master's degree or higher 03 I understand ... to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notifications to be...information will only be disclosed to an assigned background investigator if he/she is deemed suitable for the job… more
    The County of Los Angeles (08/04/25)
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  • Director, SM Medical Affairs, LSM Platform

    BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
    …business team, regional leadership in the Medical Affairs Function and the Associate Director of Medical Affairs in Specimen Acquisition to align and prioritize ... by the BU + Reviews and approves proposals for IIS ( Investigator -Initiated Studies) and Collaborative Studies + Reviews and approves advertising, educational,… more
    BD (Becton, Dickinson and Company) (06/18/25)
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