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...
Supporting all who care While working with every member of our care team, you'll help deliver on the promise of total health... and maintain opththalmic equipment. Perform administrative duties: Maintain inventories, perform third party claims processing...
role Bachelor's degree Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), or Accredited Health Care... for healthcare claims in one or more of the following areas: (1) Partial Hospitalization and Intensive Outpatient Programs; (2...
Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), or Accredited Health Care Fraud Investigator (AHFI... be. Job Overview: The Investigator will be assigned to conduct pre-payment reviews of medical records for healthcare claims...
, health insurance coding, provider relations, or another similar role Bachelor's degree Certified Fraud Examiner (CFE... will be assigned to conduct pre-payment reviews of medical records for healthcare claims in one or more of the following areas: (1...
of the Deputy Commissioner for West Virginia Children's Health Insurance Program (WVCHIP), this position oversees the... operational and financial processes of the Children's Health Insurance Agency, which administers the statewide Children's Health...
and follow up on restitution payments, police reports, and insurance claims when applicable. Prevention & Compliance Assist... judgment in high-stakes situations. Preferred Certifications (a plus, but not required): Certified Fraud Examiner (CFE...
and claims investigations on less complex accounts as assigned. Participates in individual training opportunities to enhance... less complex Equipment Breakdown claims as requested by the claim department. Evaluate elements of the breakdown, extent of damage...
training with Examiner Training Unit and Organizational Change & Alignment. Coordinates with appropriate directorate... delivery of efficient customer service. Responsible for processing EPMSs, expense claims, regional award nominations...
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...
health compensation and pension exams for service connected issues and claims. The hours at the clinic fall between 8:00... am and 4:00 pm. Job Description: Mental health issues addressed during the exams may include depression, military sexual...
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...
individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication... to examiner reports on claims adjudication. Compiles, reviews, and analyzes management reports and takes appropriate action...
requests. Determines the appropriate Disability Benefit Questionnaires (DBQ) to assign to specified health conditions... identified during order request review. Accurate review of the claims file and correctly labeling relevant evidence ensures...
, including a wide variety of mechanisms, e.g. dashboards, APIs, real-time alerts, etc. Experience with health care claims... health plans, risk-bearing providers/their management services organizations (MSOs), and third-party administrators (TPAs...
Liability Examiner I and General Liability Examiner II FULLTIME LOCATION: Hybrid – 2 days a week in Downers Grove, IL, St....) JOB DESCRIPTION: Effectively manages a caseload of indemnity claim files, including very complex and litigated claims. The caseload...
requests. Determines the appropriate Disability Benefit Questionnaires (DBQ) to assign to specified health conditions... identified during order request review. Accurate review of the claims file and correctly labeling relevant evidence ensures...
, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including... population health, utilization review, managed care organization quality review, and quality assurance for programs serving...
, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including... population health, utilization review, managed care organization quality review, and quality assurance for programs serving...
individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication... to examiner reports on claims adjudication. Compiles, reviews, and analyzes management reports and takes appropriate action...