- Stony Brook University (Stony Brook, NY)
- …University's Renaissance School of Medicine (RSOM) is seeking applications for a clinical pathology faculty member at the Assistant, Associate, or Full Professor ... (Clinician Educator track) to provide laboratory director oversight for the clinical microbiology laboratory section of the Stony Brook University Hospital's… more
- Stony Brook University (Stony Brook, NY)
- …of Psychiatry at the Renaissance School of Medicine is seeking an investigator with expertise in the development, validation, and implementation of AI applications ... developmental trajectories. Stony Brook University maintains a broad range of pre- clinical and clinical research cores, including fMRI, PET, ECT,… more
- Centene Corporation (Tallahassee, FL)
- …practices + Consult investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities + Performs ... LPC, LCSW, LMHC, PT, OT or ST license and 2+ years of related clinical experience in the field of obtained license. Experience in provider education preferred.… more
- Providence (Oakland, CA)
- **Description** ** Investigator External Audit Special Investigations Unit \*Remote The SIU Audit Investigator supports the compliance related activities ... of the Special Investigations Unit (SIU) at the Health Plan. This role...activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and… more
- AmeriHealth Caritas (Columbus, OH)
- …Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse investigations . + Conducts ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Clinical Investigator ** to join #TeamMVP. This is the opportunity for you ... if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication...experience involving economic or insurance related matters. + A clinical investigator must have in addition to… more
- Sanford Health (Fargo, ND)
- …analytics, investigation , claim auditing and other areas related to Special Investigations . Completes reports of investigative findings and recommends ... investigation /audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred Nursing… more
- Elevance Health (Atlanta, GA)
- ** Clinical Fraud Investigator II - Registered...aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for...experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or… 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 ... Operations) and supporting systems. (BREADTH). + Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible… more
- Molina Healthcare (Milwaukee, WI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case...experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software including… more
