recover corporate and client funds paid on fraudulent claims. Claim reviews for... appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. Responsible for indepen...
The role is pivotal in recovering corporate and client funds that have been paid out on fraudulent claims. Key responsibilities include:... - Conducting claim reviews to ensure appropriate coding, engaging in data mining, entity review, and making referrals t...
healthcare fraud. This role is pivotal in recovering corporate and client funds that have been paid out on fraudulent claims. The responsibilities include: -... Conducting claim reviews to ensure appropriate coding and utilizing data mining, entity review, and law enforcement referrals...
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manner. Reviews and makes recommendations on outcomes of investigations in a prompt and expeditious manner. Provides guidance and recommendations to claims leadership and associates on... claims resolution. Promotes and provides... “On Your Side†customer service. Continuously monitors suspicious claims an...
manner. Reviews and makes recommendations on outcomes of investigations in a prompt and expeditious manner. Provides guidance and recommendations to claims leadership and associates on... claims resolution. Promotes and provides... “On Your Side†customer service. Continuously monitors suspicious claims...
in order to detect fraudulent, abusive or wasteful activities/practices.... analyzes data to detect fraudulent, abusive or wasteful payments... to providers and subscribers. Prepare statistical/financial analyses and reports to document findings and maintain up-to-date case files for management review. Prepare final...
in order to detect fraudulent, abusive or wasteful activities/practices.... include: Using appropriate system tools, analyzes data to detect fraudulent, abusive or wasteful payments... to providers and subscribers. Prepares statistical/financial analyses and reports to document findings and maintains up-to-date case files...
Investigator - Virginia Medicaid Schedule: 1-2 days per week in the office (Hybrid 1) Location: Hybrid (remote and office) Salary Range: $77,028 to $132,048 Company Overview: - **MEMBERS ONLY**SIGN UP NOW***. is a Fortune 25 company dedicated...
Identification and Investigation of Fraudulent Claims Bold Headlines:... in healthcare fraud detection and recovery - Independent identification and investigation of fraudulent claims - Schedule: 1-2... days per week in the office (Hybrid 1) - Location: Hybrid model (remote an...
Friendly Job Title: Senior Investigator - Healthcare Fraud H1: Join Our Team as a Senior Investigator - Healthcare Fraud H2: Discover a Rewarding Career at **MEMBERS ONLY**SIGN UP NOW***. Senior Investigator - Healthcare Fraud - Full-time position with...
manner. Reviews and makes recommendations on outcomes of investigations in a prompt and expeditious manner. Provides guidance and recommendations to claims leadership and associates on... claims resolution. Continuously monitors suspicious... claims and claims payment operations... in pursuit of fraudulent ac...
and expeditious manner. Reviews and makes recommendations on outcomes of investigations in a prompt and expeditious manner. Provides guidance and recommendations to claims leadership and associates on... claims resolution. Promotes and provides... customer service. Continuously monitors suspicious claims and clai...
manner. Reviews and makes recommendations on outcomes of investigations in a prompt and expeditious manner. Provides guidance and recommendations to claims leadership and associates on... claims resolution. Promotes and provides... “On Your Side†customer service. Continuously monitors suspicious claims an...