- Molina Healthcare (Lexington, KY)
- …health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... with other internal departments, including Compliance, Corporate Legal Counsel, and Medical Officers in order to achieve and maintain appropriate anti-fraud… more
- Johns Hopkins University (Chicago, IL)
- …+ Experience in Occupational Medicine, Workers' Compensation, and DOT exams + DOT Medical Examiner preferred. + Certified Urine Drug Screen Collector preferred. ... required for lab testing provided on-site. + Maintain patient medical records. _Work collaboratively with the Benefits and Safety...wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. +… more
- Citizens (Johnston, RI)
- …Risk Oversight will support the independent Risk Oversight of the Fraud and Claims divisions and all aspects of Fraud risk across the organization. Independent risk ... + Understanding of how Fraud works in consumer and commercial + Certified Fraud Examiner Hours & Work Schedule Hours per Week: 40 Work Schedule: 8AM-5PM EST Pay… more
- Highmark Health (Montgomery, AL)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more