- Elevance Health (Gilbert, MN)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that… more
- CVS Health (Hartford, CT)
- …with heart, each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
- Command Investigations (Atlanta, GA)
- Seeking experienced Claims /SIU and/or Workers' Comp. Investigators for Insurance Investigations that include Recorded Statements, Accident Scene, and ... Visit our website and find out why at www.GoCommand.com. The SIU/WC Investigator should demonstrate proficiency in the following areas: + Multi-lines Investigations… more
- The Robison Group (Carbondale, IL)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. This ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... required. Familiarity with CPT and ICD (coding and CCI edits). + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ,… more
- Mount Sinai Health System (New York, NY)
- …Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with ... analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator.… more
- Mount Sinai Health System (New York, NY)
- …Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. **Qualifications** + Associates ... + 3 years experience in medical billing or health claims , with experience in IDX billing systems in a...Accounts Receivable and current billing concerns. + Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in… more
- Mount Sinai Health System (New York, NY)
- …billing system and/or payors to facilitate the accurate and timely payment of claims . **Qualifications** + High School diploma/GED. + Three years of experience in a ... medical billing or insurance claims environment. **Responsibilities** 1. Reviews and resolves moderate to...edits including TES, BAR and eCommerce. 3. Mentors less experienced staff and may assist Billing Manager in training… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- **Job Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for ... of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including contract research organizations) and ensure that… more
- The County of Los Angeles (Los Angeles, CA)
- …experience applies to a person who has completed an apprenticeship program or is an experienced worker, not a trainee, and is fully qualified and able to perform a ... steps to view correspondence, and we will not consider claims of missing notices to be a valid reason...who has completed an apprenticeship program or is an experienced worker, not a trainee, and is fully qualified… more