, reporting and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health... of Managed Health Care (DMHC) claims data submissions for L.A. Care and its Plan Partners (PPs) and delegates done each quarter...
STGi is currently seeking an Occupational Health Physician Assistant for Federal Occupational Health (FOH) Clinical... Health Services (CHS) to support the Medical Employability Program (MEP). The candidate must reside in the District...
Requisition No: 859230 Agency: Management Services Working Title: HEALTH INSURANCE FRAUD ANALYST II - 72004150... Total Compensation Estimator Health Insurance Fraud Analyst II Division of State Group Insurance State of Florida...
Requisition No: 859230 Agency: Management Services Working Title: HEALTH INSURANCE FRAUD ANALYST II - 72004150... Total Compensation Estimator Health Insurance Fraud Analyst II Division of State Group Insurance State of Florida...
Job Description: Responsibilities Prominence Health is a value-based care organization bridging the gap... between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates...
Analyze and evaluate claim processes specific to professional, hospital, ambulatory surgical center, home health and durable... claims were adjusted correctly, resulting in expected recovery/savings. Perform claims system extracts and create reports...
a visionary Senior Director of Payment Integrity & Cost Containment to lead enterprise-wide initiatives that ensure claims... of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies...
, Business or related field EXPERIENCE Required 3 years of relevant, progressive experience in the health insurance... industry and/or healthcare fraud investigations Preferred 1 year in Financial Analysis in an acute care hospital or health...
Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) Qualifications Bachelors degree and 5 years related.... CPC or equivalent required Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) preferred...
the AAPC Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) Responsibilities Medium... interface with health plan claims system, the vendor fraud analytics system, the SIU case management system, and other systems...
include reviewing treatment progress, recommending medical treatment interventions to the third-party claims examiner...' compensation claims by supporting employees who have experienced work-related injuries or illnesses. In this role, you will ensure...
but limited to; Pharmacy, DEM, Mental Health, Behavioral Health, Hospice, Home Health, claims, or claims processing preferred..., detect, and correct suspected and identified issues of fraud, waste, and abuse in the health care environment, including...
in a health plan, SIU, or government agency. Strong knowledge of healthcare billing and coding (ICD, CPT/HCPCS, NDC), claims... be required) POSITION PURPOSE Umpqua Health Alliance is seeking a seasoned Senior Program Integrity Investigator to lead complex fraud...
containing procedures and training materials for staff; train new hires and promotional hires for Unemployment Claims Taking... and Adjudication of Unemployment Claims. This unit also is responsible for creating and updating guides to be used in training staff...
and claims investigations on less complex accounts as assigned. Participates in individual training opportunities to enhance... equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim...
Job Description: Responsibilities Prominence Health is a value-based care organization bridging the gap... between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates...
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care... to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together...
and claims investigations on less complex accounts as assigned. Participates in individual training opportunities to enhance... equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim...
Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations... claims and other data. - Create financial damage models for use in litigation. - Conduct asset valuation. - Conduct...
Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations... claims and other data. - Create financial damage models for use in litigation. - Conduct asset valuation. - Conduct...