Medicare Investigations Lead - Complaints & Referrals (Remote)
Peraton
- Remote job
Peraton, a leading national security and IT solutions provider, seeks a Complaints/Referrals Team Lead for Medicare within SafeGuard Services (SGS). The role focuses on quality objectives, workload oversight, and case development for referrals to law enforcement or other entities.You will mentor investigators and guide workflow development while maintaining independence within established policies. Responsibilities include managing monthly workload reviews, QC, and prioritizing referrals andJ-18808-Ljbffr Peraton
$66k - $106k
Complaints/Referrals Team Lead - MedicareJob LocationsUSResponsibilitiesSafeGuard Services (SGS), a subsidiary... ...of Peraton, performs data analysis, investigation, and medical review to detect,... ...candidates will have:Knowledge of Medicare requirements, laws, rules and regulations...Remote workComplaintsContract workFor contractorsShift workNight shift$41.25k - $75.63k
...the company’s success. As a Detection & Investigation Analyst Lead within PNC's Zelle Fraud organization, you will be based remotely within the PNC footprint. Work may be performed... ...File security incident reports and complaints when required Apply authentication and KYC...Remote workComplaintsFull timeTemporary workPart timeWork experience placementWork at office$83.97k - $107.22k
...Primary Location Remote Department PS Network... ...mandated authorities for investigations. Utilize the... ...plan. Collaborate with referral sources and health care... ...documents, and analyzes complaints associated with therapy... ...place to work A Leading Disability Employer as...Remote workComplaintsFull timeTemporary workWork experience placementLocal areaShift workWeekend work$56.78k - $99.29k
...options Telework eligible No Remote job No Relocation expenses... ...oversight of all stages of investigations conducted by assigned Department... ...emergency calls, complaints and other calls for service;... ...from Department of Defense referral system for displaced employees...Remote workComplaintsPermanent employmentFull timeWork experience placementLocal areaRelocationTrial periodRelocation packageShift workRotating shiftWeekend workAfternoon shift- ...fraud, waste, and abuse across Medicare, Medicaid, Commercial, and... ...qualify improper-payment leads, then own each one end to end... ...will not manage anyone. Strong investigators here come from healthcare... ...to customers. Keep payer complaints at zero and minimize provider...Remote workComplaints
$55k - $60k
...Coordinator - Call Center Lead - Texas Institute for... .... Ability to work remotely within the state of Texas... ...policies, service standards, referral practices, and... ...in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or...Remote workComplaintsFull timeFor contractorsWork at officeMonday to FridayShift workWeekend workAfternoon shift- ...Location: Washington, DC Metro Area / Remote Schedule: Full-Time, Monday-... ...civil rights and civil liberties complaints. Responsibilities: Review and process... ...reports and case summaries; edit referral, closure, and investigative documents; and safeguard sensitive...Remote workComplaintsFull timeContract workMonday to Friday
- Peraton is seeking an Investigative Team Lead to oversee investigations in Medicare/Medicaid domains and mentor staff. The role emphasizes quality objectives, timely case development, and referrals to law enforcement or other entities. Key duties include workload oversight...Remote workFlexible hours
- ...Quality Lead To play a key role in co-ordinating and supporting the activities of... ...while monitoring safeguarding, incidents, complaints, risk assessments, recruitment and... ...feedback and concerns, ensuring these are investigated and managed appropriately in line with practice...Remote workComplaintsWork at officeLocal area
- ...Overview As Strategic Partnerships Lead, you will build two-way... ...much as revenue. The role is remote, with regular travel for partner... ...Customer Introductions Build referral and co-selling partnerships... ...Employee outcomes and complaints Whether products deliver good...Remote workComplaintsSummer workWork from homeHome office
- ...apply now. We are currently seeking a APAC Lead Investigator, Employee Relations (HR Director) to join our team in Remote, Wilayah Persekutuan Kuala Lumpur (MY-14),... ..., and cross-country investigations involving complaints, ethics issues, conduct, harassment, discrimination...Remote workComplaintsWork at officeLocal areaFlexible hours
- .... This is a client-facing Language Lead position. In addition to linguistic work... ...a team of linguists. This is a remote freelance position open to candidates... ...TransPerfect with professionalism. Review and investigate client complaints and quality-related issues, determine...Remote workComplaintsHourly payFull timeContract workFreelanceWorldwide
$159k - $169k
...to say “yes” to any patient referral rather than a multitude of exclusionary... ...-First Mindset Fully-Remote Business Casual... ...Overview: The BHMP Team Lead provides direct patient care... ...timely resolution of patient complaints. Coordinate with Clinical...Remote workComplaintsFull timeCasual workWork at office$153.3k - $295.9k
...The work The SAP Functional Lead is responsible for leading complex... ...government security clearance #LI-Remote #LI-PlatformEngineeringMgmt #LI-... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFull timeLive inWork at officeLocal area$88k - $96k
...to say “yes” to any patient referral rather than a multitude of exclusionary... ...: The Therapy Team Lead provides direct patient care... ...timely resolution of patient complaints. Coordinate with... ...Requirements: This is a fully remote position but may require in-person...Remote workComplaintsFull timeWork at officeWork from homeFlexible hoursShift work- ...at Telix The Quality Control Lead is a site-based role responsible... ...routine testing, laboratory investigations, equipment qualification, and... ...inspections, and customer-complaint Site Readiness and Improvement... ...medicine. We have hybrid and remote employees located all around...Remote workComplaintsContract work
- ...DecisionPoint seeks an API Platform Lead to oversee the enterprise API... .... This position is fully remote. Duties & Responsibilities... ...disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFor contractorsLocal area
$56.04k - $72.85k
...candidate to fill the Lead Medical Support Assistant... ...eligible: No Remote job: No Relocation expenses... ...background/security investigation. Selected applicants... ...about the Act and the complaint process, visit Human Resources... ...review is complete, a referral certificate(s) is...Remote workComplaintsPermanent employmentFull timePart timeFor contractorsTraineeshipWork experience placementSeasonal workWork at officeWork from homeRelocationTrial periodMonday to Friday- ...DecisionPoint seeks a Cybersecurity Lead / ISSM Support professional to... ...leadership. This position is remote, with a preference for candidates... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFull timeContract workFor contractorsLocal area
- ...DecisionPoint seeks an AI Integration Task Lead to lead the planning,... ...outcomes. This position is remote, with Chicago-area candidates preferred... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFull timeContract workFor contractorsLocal area
- ...Configuration Management (CM) Lead to direct and mature... ...readiness. This position is fully remote. Duties & Responsibilities... ...by a Tier 5 background investigation. Education (Required)... ...(a) in response to a formal complaint or charge, (b) in furtherance...Remote workComplaintsFor contractorsLocal area
- ...Adoption & Workforce Enablement Lead to develop and deliver workforce... ...workflows. This position is remote, with Chicago-area candidates preferred... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFull timeContract workFor contractorsWork at officeLocal area
$320k - $340k
...Our partner is looking for a Lead Medical Director, Utilization... ...necessity reviews across outpatient referrals, inpatient admissions, and... ..., access, and outcomes. This remote-first role combines hands-on... ..., case reviews, appeals, complaints, and utilization management performance...Remote workComplaintsFull timeWork at officeFlexible hours$95.8k - $153.2k
...The Opportunity: The FinOps Lead will oversee the development and... ...connection across our teams. Through a remote‑first, flexible environment, we... ...is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFull timeLocal areaFlexible hours$107k - $112k
...DecisionPoint seeks a Dev Lead / Scrum - Data & Integration to... ...standards. This position is fully remote. Duties & Responsibilities... ...disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action,...Remote workComplaintsFor contractorsLocal area$31.2k - $38.11k
...the release of medical records. In this remote position, you will handle phone, email,... ...timely, and professional service. You will investigate questions, resolve issues, and maintain... ..., promptly reporting concerns, complaints, incidents, or operational issues....Remote workComplaintsHourly payFull timeWork at officeMonday to FridayShift work$48.7k - $50k
...Location Remote - Miami, FL, United States Base Pay $48,696.00 - $50,000.00 /... ...Year Job Category Provider Relations Lead, NEMT Provider Relations, Hiring PR... ...visits and provider observations. Investigate escalated complaints or operational issues and implement corrective...Remote workComplaintsFull timeContract workWork at office$320k - $340k
...clinical policies. The Lead Medical Director,... ...evaluation of all outpatient referrals and inpatient direct... ...Local and National Medicare Coverage Determinations... ...case reviews, appeals, complaints, and UM performance data... ..., we embrace a remote-first culture that supports...Remote workComplaintsFull timeWork experience placementWork at officeLocal areaFlexible hours- ...Eursdale Companies, LLC is seeking a Compliance Investigator/Program Support Analyst to support a DHS program reviewing civil rights and civil liberties complaints in the Washington, DC area, with remote work options. The role involves processing complaints, maintaining...Remote workComplaints
$50k - $55k
...including inspections, residue sampling, and investigations. Priority will be given to candidates... .... Location: This position is remote, requiring travel within MCS’ service territory... ...agency affiliates. Investigates complaints to protect the integrity of the organic...Remote workComplaintsFull timeSeasonal workWork at officeLocal areaLong distanceMonday to FridayWeekend workAfternoon shift3 days per week
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