. New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred... personnel. Keep abreast of Federal and State Anti-Fraud investigation and reporting requirements including HIPAA, CMS, Medicare...
Management (audit requirements, fraud prevention, Know Your Customer (KYC) and customer information profile (CIP)). Reach out...
and escalate cases of suspected fraud. Resolve and accurately log all customer complaints in the appropriate system. Review...