- Molina Healthcare (Bowling Green, 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and evaluate complex potential fraud, waste, or abuse, including pre-pay and/or post-pay medical claims reviews to determine valid cases for appropriate action; ... Skills and Experience * Bachelor's degree. * Certified Fraud Examiner (CFE) in good standing through the Association of...offer a comprehensive benefits package which may include: * Medical , dental, and vision insurance * Life insurance *… more