- Elevance Health (Nashville, TN)
- …responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse . **How you will make an impact:** + Examines ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. +...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
- Henry Ford Health System (Troy, MI)
- …compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse prevention and control. + Performs medical record ... arrangements and benefit design. + Keep current with industry fraud , waste, and abuse trends and activity...HCPCS, and ICD-10 coding systems and working knowledge of healthcare compliance are required. + Ability to work with… more
- Louisiana Department of State Civil Service (LA)
- …to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud Control Unit (MFCU)… more
- Robert Half Legal (Glen Allen, VA)
- …documents. * Familiarity with healthcare law, including HIPAA, telemedicine, and fraud and abuse regulations. * Ability to manage contract drafting, ... and healthcare transactions. * Identify and mitigate risks related to fraud , abuse , HIPAA regulations, and telemedicine. * Handle medical malpractice cases… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …development of compliance internal monitors and audit protocols and the prevention of fraud , waste and abuse . + Develops compliance monitors and audit protocols ... of claims audit or investigation. + Maintains awareness of fraud , waste and abuse laws and regulations...and regulations and current industry changes that may impact healthcare revenue cycle services domestic and international through personal… more
- Amentum (Albany, NY)
- …and assets. + Analyze large and complex healthcare claims datasets to identify fraud , waste, and abuse patterns. + Design and run SQL queries, models, and ... data analytics. + Support development of internal best practices and workflows for healthcare fraud detection. **Required Qualifications:** + Must be able to… more
- Ankura (Chicago, IL)
- …complex engagements . Support expert witness reports and testimony with respect to fraud and abuse , competition, government healthcare program and ... medical devices. Familiarity with expert reports and/or testimony with respect to fraud and abuse matters, monitorships, government proceedings, and class… more
- Abbott (Lake Forest, IL)
- …and reimbursement by government programs including, for example, laws related to fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA regulation ... Abbott is a global healthcare leader that helps people live more fully...representing a regulated company, including knowledge of corporate law, fraud and abuse laws, privacy laws and… more
- Methodist Health System (Dallas, TX)
- …not limited to, state specific health care laws and regulations, Medicare/Medicaid rules, fraud and abuse including Stark and anti-kickback laws and regulations, ... including but not limited to Medicare/Medicaid reimbursement, HIPAA, AKS, self-referral prohibitions, and fraud and abuse . + Good working knowledge of the key… more
- Sanofi Group (Cambridge, MA)
- …legal matters, particularly in the area of advertising and promotion, fraud and abuse , and other applicable healthcare laws. We are an innovative global ... to identify potential legal issues (focusing on promotional matters, regulatory issues, and fraud and abuse ) as well as proposed solutions to mitigate risk… more