- Highmark Health (Charleston, WV)
- …and Thursdays This job is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of ... information in applicable case management tracking systems. **ESSENTIAL RESPONSIBILITIES** + Claims Reviews/ Investigation : Arrange for collection of claims … more
- CVS Health (Charleston, WV)
- …Investigations Unit (SIU)! **Position Summary** The SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- Travelers Insurance Company (Charleston, WV)
- …of businesses of all sizes. The BSI Claim Counsel team conducts thorough investigation , analysis, evaluation, and disposition of claims and claim litigation to ... optimize claim results. Travelers' Cyber Claim Team is responsible for handling claims focusing on cyber privacy and security breach incident response, computer… more
- Allied Universal (Beckley, WV)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation ... credit card to cover fuel and travel expenses** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types,… more
- Otsuka America Pharmaceutical Inc. (Charleston, WV)
- …or medical device product candidates. + Interprets and communicates results of Phase I-IV investigations in preparation for a new drug. + Acts as the signatory on ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director and 6-9...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Humana (Charleston, WV)
- …and/or state requirements related to Provider Clinic operations, billing, investigations , and processes. Coordinates site visits for regulators, coordinates ... cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must… more
- Carrington (Charleston, WV)
- …system, including but not limited to, analyzing complaints, investigating claims , retaining outside counsel where appropriate and providing outside counsel ... circulating agreements for signature. + Take lead in pre-claim title investigation /review, including reviewing title records, organizing documents and creating a… more