Senior FWA Investigator, Healthcare Claims Analytics
$46.99k - $112.2kHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is hiring a Sr. Analyst for Fraud, Waste, and Abuse in Missouri. This role involves detecting and investigating fraud cases within healthcare services and ensuring compliance with regulatory standards. Candidates should have 3-5 years of experience, coding certification, and a strong understanding of medical billing. The anticipated pay range is between $46,988 and $112,200 annually. Enjoy insightful benefits aimed at fostering a supportive workplace. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$46.99k - $112.2k
...Enhancement in Louisiana is looking for a Senior Investigator to conduct investigations of healthcare fraud and abuse. This role... ...in healthcare fraud, strong analytical and research skills, and proficiency... ...investigating Medicaid fraud claims, documenting case activities,...SeniorClaimsWork at office- CVS Health is hiring a Senior Informatics Manager in Louisiana to oversee data... ...lead a team in delivering advanced analytics while collaborating with financial... ...requires substantial experience in healthcare analytics, including claims data, and a strong ability to communicate...SeniorClaims
$67.9k - $199.14k
...an exciting opportunity for a Senior Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will... ...analytics, interpreting large healthcare datasets, and translating... ...leveraging medical and pharmacy claims, encounter, provider, and membership...SeniorClaimsRemote jobHourly payFull timeTemporary workWork experience placementLocal area$46.99k - $122.4k
...Hispanic Alliance for Career Enhancement is seeking a dedicated investigator for healthcare fraud cases based in Missouri, Louisiana. The role... ...degree or relevant experience is required, along with strong analytical and communication skills. The position offers a...Senior$46.99k - $112.2k
Position Summary As a Senior Investigator you will conduct high‑level, complex... ...known or suspected acts of healthcare fraud and abuse. You will... ...payment of fraudulent claims submitted to the Medicaid lines... ...do pivot tables). Strong analytical and research skills. Proficient...SeniorClaimsFull timeTemporary workWork at officeLocal area$46.99k - $122.4k
...groups in a prepayment environment Investigates to prevent payment of fraudulent claims committed by insured's,... ...investigation and prosecution of healthcare fraud and abuse matters. Demonstrates... ...Health fraud cases. Strong analytical and research skills using health...SeniorClaimsHourly payFull timeTemporary workLocal area$89.17k - $142.68k
...are seeking a highly skilled Senior Data Analyst with deep expertise... ...ACA data flows (enrollment, claims, supplemental), HCC modeling,... ...outputs, along with advanced analytical and data validation skills.... ...procedures are used to access, investigate, and analyze data. Develop,...SeniorClaimsWork at officeLocal areaRemote workFlexible hours2 days per week- ...for Career Enhancement is looking for a Senior Coordinator for the Minute Clinic Accounts... .... This role involves managing medical claims, identifying solutions to billing issues... ...options. Join a team dedicated to simplifying healthcare and making a difference in people's...SeniorClaims
$46.99k - $112.2k
...Fraud, Waste, and Abuse (FWA) will assist in detecting, investigating, remediating and... ...transportation, and other healthcare services. The Sr. Analyst... ...correct coding, review claims, and billing data from all... ...Responsibilities Leverage analytical skills to review claims...SeniorClaimsHourly payFull timeTemporary workWork experience placementLocal area- Job Summary Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating...ClaimsWork experience placement
- ...experienced professional to design and execute real-world evidence (RWE) studies using EMR and claims data. The ideal candidate will have a strong background in statistics, RWD/RWE analytics, and causal inference methods. The position requires collaboration across various...SeniorClaims
$46.99k - $122.4k
Position Summary The Senior Business Analyst supports execution and... ...follow‑up needs Data & Analytical Expectations Maintain working... ...operations, compliance operations, or healthcare operations Strong Excel,... ...with medical and/or pharmacy claims data Education Bachelor's...SeniorClaimsRemote jobFull timeLocal area- Qlarant is looking for a dedicated professional to conduct audits and investigations into claims integrity in Missouri. The role involves analyzing data, addressing customer concerns, and communicating findings to various stakeholders. The ideal candidate will have a Bachelor...Claims
- Sedgwick is seeking a Claims Examiner - Property in Louisiana, Missouri, to analyze and process complex property claims. The ideal candidate will have five years of claims management experience, knowledge of construction basics, and property estimating software. This role...SeniorClaims
- The Hispanic Alliance for Career Enhancement is seeking a Senior Principal Trainer in Louisiana, Missouri. This individual will lead... ...Qualified candidates should have over 5 years of experience in healthcare IT or enterprise training and must possess Epic certification....SeniorFull time
$78k - $95k
...opportunity for you! We are currently seeking a Senior Contract Analyst to join our dynamic... ...Contract Analyst performs a variety of analytical, administrative, and technical functions... ...Management System. Coordinate with the Claims and Contract Specialist to ensure newly...SeniorClaimsContract workTemporary workWork at office$49k - $76.23k
A healthcare management firm in Louisiana is seeking auditors to improve governmental accounting practices. Candidates should be detail... ...Ideal candidates will have a degree or CPA certification and strong analytical ability. #J-18808-Ljbffr Savoy Medical Management GroupSeniorRemote jobFlexible hours- ...open access to quality patient centered healthcare in the communities in which we live. RKM... ...and staff management experience Strong analytical and data interpretation skills with executive... ...functions Monitor and resolve claim denials, coding issues, and reimbursement...ClaimsFull timeWork at officeMonday to Friday
- ...DeQuincy, LA. The role involves the timely submission of various claims and preparing reports for leadership. Candidates should have... ...any issues affecting service. This position is full-time on-site, offering a crucial role in a healthcare setting. #J-18808-Ljbffr AhhmgtClaimsFull time
- ...coding principles. Excellent decision making, problem solving, analytical and quality management skills. Job Duties Accurately assigns... ...departmental monthly goals, which may include DNFB, Pre‑AR, denials and claim edits. Verifies correct discharge disposition based on medical...SeniorClaimsRemote jobWork experience placementLocal areaImmediate startNight shift
$18.5 - $42.35 per hour
...lower costs by developing new approaches. The Minute Clinic Accounts Receivable Associate, Senior Coordinator, will be responsible for: Managing a high volume of medical claims that have denied by refuting the denials within payer guidelines through accurate review,...SeniorClaimsHourly payFull timeContract workTemporary workWork at officeLocal area$34 per hour
...Intern, Disputes & Economics (Healthcare and Life Sciences) Ankura is... ...with complex disputes, investigations, regulatory and compliance,... ...audit, clinical coding, data analytics, financial, valuation, and systems... ...methods; prescription drug claims submission and payment;...ClaimsPermanent employmentFull timeTemporary workSummer workInternshipSummer internshipWork visa- Highmark Health is seeking a skilled Associate Actuary for a senior level actuarial analyst position focused on developing actuarial studies and analyses. This role requires participation in the Actuarial Executive Development Program while mentoring less experienced staff...SeniorRemote job
- ...Licensed Practical Nurse (LPN) to provide vital health services to seniors in Farmerville, LA. This full-time role requires collaboration... ...documentation and work with compassion in a supportive healthcare environment. A current LPN license is mandatory for applicants...SeniorFull timeDay shift
- Prolerity Clinical Research, Inc. is seeking a Sub-Investigator in Louisiana, US, to join its clinical research team. You'll perform physical... ...for clinical research. You will collaborate with other healthcare professionals to advance medical practices and ensure high standards...
$67.9k - $182.55k
...company in the United States, is seeking a Senior Manager, Strategic Planning, to support... ...like call center, digital engagement, claims, and financial administration. This highly... ...developing and executing strategies for healthcare products, services, and programs. High...SeniorClaimsHourly payFull timeTemporary workWork experience placementWork at officeLocal area- A healthcare provider is seeking an experienced LPN for their Senior Care Flexpool. This temporary position offers flexible scheduling and competitive pay, allowing you to provide care across WK’s Senior Care facilities. The ideal candidate should have at least one year...SeniorTemporary workFlexible hoursDay shift
- A leading healthcare provider in Louisiana is looking for an Occupational Therapy Assistant to provide therapeutic interventions and contribute to patient program development. The ideal candidate should possess current licensure, CPR certification, and strong communication...SeniorDaily paidPart time
- Description Becker & Company is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is perfect... ...investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability...ClaimsFlexible hours
- ...Pharmacy industry looking for additional income, an established healthcare sales professional, or looking to break into Medical Sales,... ...ongoing coaching Great Commission! We pay commission on a per-claim basis, which means you make money every time someone uses our Pharmacy...ClaimsCurrently hiringWork at office
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