- Elevance Health (Chicago, IL)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II ** is responsible for identifying… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines ... substantiating referrals, case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and… more
- Astellas Pharma (Northbrook, IL)
- …services, advisory boards and councils, data sharing and data licensing, investigator -initiated studies, regulatory and quality agreements + Providing legal and ... contract drafting and negotiations with potential business partners and collaborators and ( ii ) strategic projects and key initiatives of the T&M function + Providing… more
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