Clinical Provider Fraud & Abuse Auditor II
The Elevance Health Companies, Inc.
The Elevance Health Companies, Inc. is seeking a Clinical Provider Auditor II in Atlanta, Georgia. This role involves identifying potential fraud and abuse risks through thorough claims analysis and teamwork with the Special Investigation Unit. Candidates will need an AA/AS degree, a minimum of three years of medical coding/auditing experience, and a relevant coding certification. The position is largely in-office with some flexibility. Elevance Health values diversity and inclusion in the workplace. #J-18808-Ljbffr The Elevance Health Companies, Inc.
- Elevance Health is seeking a Clinical Provider Auditor II in Atlanta, Georgia. This hybrid role requires 1‑2 days a week in the office, promoting... ...responsible for identifying potential risks related to fraud and abuse through examination and analysis of claims. Minimum...FraudWork at office2 days per week1 day per week
- Clinical Provider Auditor II - Payment Integrity SIU Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration... ...entities that may pose potential risk associated with fraud and abuse, and for assessing claims for compliance with billing...FraudWork at officeLocal areaDay shift2 days per week1 day per week
- ...customers through prize payouts. We also provide educational opportunities for Hope... ...and addressing potential losses from fraud, waste, or abuse, evaluating the effectiveness of internal... ...within The Institute of Internal Auditors’ Code of Conduct. Participates in pre-...FraudCasual workFlexible hours
- Auditor II - Risk Management Job Code: 3248 Requirement #: 5780 Delta Community Credit Union Administrative Office - Riverwood 200 Full... ...engagements as needed to support corporate goals and initiatives. They provide assistance with the regulatory examination process as well as...SuggestedFull timeWork at officeWork from home
- Cooper Lighting Solutions is looking for an Auditor II to join their team in Atlanta, GA. The position focuses on risk management, conducting... ...analytical and communication skills are essential. The role provides opportunities for professional development and may include...SuggestedRemote job
$95k - $110k
Clinical Compliance and Operations Auditor Atlanta, Georgia, United States Position Summary The Clinical Compliance and Operations Auditor is responsible... ...reviews from payors and accreditation bodies while providing data-driven feedback to leadership. Duties and Responsibilities...Work experience placementWork at officeLocal areaMonday to FridayShift work- ...supervision of the Executive Director, Compliance Audit, the Manager, Clinical Compliance Audit has primary oversight of the enterprise-wide... ...auditing program. The Manager, Clinical Compliance Audit provides oversight and manages clinical compliance audits, and applicable...Work experience placementLocal area
$23.7 - $39.1 per hour
Credentialing Analyst, Infusion Clinics/Nursing Hybrid: This role requires associates... ...collaboration and connectivity, while providing flexibility to support productivity... ...support during accreditation renewals. Fraud, Waste and Abuse annual attestation submission to health...FraudHourly payWork at officeLocal area2 days per week1 day per week- ...Clinical Referral Specialist The Clinical Referral Specialist will manage incoming... ...concerns, or other entry barriers and provides information in response to address those... ...concerns, significant legal risk questions, fraud, abuse, suspected or actual misconduct to...Fraud
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- ...Auditor Employment Type: Full-Time, Mid-Level Department: Financial CGS is seeking a highly skilled Auditor to provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions and complex...FraudFull timeWork experience placementInterim roleWork at officeLocal areaRemote workFlexible hours
- Senior Auditor Generalist Georgia State University is seeking an experienced senior internal... ...through concise progress updates. Provide credible actionable recommendations and guide... ...Certified Internal Auditor and/or Certified Fraud Examiner). Preferred Hiring...FraudWork at office
- ## Lead Auditor (Hybrid - Atlanta, GA)Applylocations: Atlanta, GAtime type: Full timeposted... ...1709**Progressive Leasing** is a leading provider of in-store and e-commerce lease-to-own... ...engagement-level risk assessments, including fraud risk considerations, to identify key...FraudCurrently hiringLocal areaRemote workShift work
$82.72k - $108.57k
...a Associate, Risk Adjustment Auditor to join our Risk Adjustment team... ...completeness, and identified clinical documentation improvement... ...EDGE) data is supported within provider encounter documentation... ...safeguard yourself from recruitment fraud here. At Oscar, being an...FraudFull timeWork experience placementRemote workWork from homeHome office$63.55k - $90.9k
...impact of more than $650 million annually and provides a safe, quality, and affordable... ...Job Summary The Senior Internal Auditor plans and conducts complex operational, financial... ...Auditor also supports advisory initiatives, fraud risk assessment activities, and...FraudWork at officeLocal area- ## Biosurgery Clinical Nurse Educator-AtlantaApplylocations: Atlanta, GAtime type: Full timeposted... ...id: R1550197As the only global provider of commercial solutions, IQVIA understands... ...maintains a zero tolerance policy for candidate fraud. All information and credentials...FraudFull timePart timeLocal areaImmediate startWorldwideFlexible hoursNight shiftWeekend work
$116k - $170k
Security Sales Specialist II, Google Cloud Fraud Defense Preferred working location: Austin, TX; Atlanta, GA; Chicago, IL; Raleigh, NC; Durham... ...business value, demonstrate product functionality, and provide a comprehensive overview of key business use cases. You will...Fraud$67.64k - $101.46k
Investigator II Location: Hybrid: This role requires associates be in the office 1-2... ...fostering collaboration and connectivity, while providing flexibility to support productivity and... ...cases against perpetrators of healthcare fraud in order to recover corporate and client...FraudWork at officeLocal area2 days per week1 day per week- The Council of State and Territorial Epidemiologists seeks a Clinical Compliance and Operations Auditor to conduct thorough onsite evaluations. This role is vital for ensuring the operational integrity of centers and preparing staff for external reviews. Key responsibilities...
- Internal Auditor - Electric Operations Atlanta, GA JOB DESCRIPTION This position will be... ...Information Systems Auditor or Certified Fraud Examiner Experience: 2+ years work experience... ...assignments Demonstrated ability to provide meaningful recommendations based on...FraudWork experience placementWork at office
$209.6k - $313.38k
...Director will lead activities related to Early Clinical Development (ECD) essential to the growth... ...through IND and proof-of-concept. Provide medical leadership for early-phase clinical... .... Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and protection...FraudTemporary workLocal areaFlexible hours$74.8k - $130.9k
...Parsons is now hiring a Roadway Engineer II to join our Sandy Springs office to support... ..., and support bid document development Provide limited guidance to junior engineers and... ...practices. To learn more about recruitment fraud and how to report it, please refer toFraudWork at officeImmediate startFlexible hours$60 per hour
...Part Time Clinical Consultant (PTCC) IQVIA/MedTech takes the approach to helping customers... ...time position will be responsible for providing case support, patient management, and... ...maintains a zero tolerance policy for candidate fraud. All information and credentials...FraudHourly payFull timePart timeImmediate startWorldwideNight shiftWeekday work- ...investigations to protect the agency from fraud, waste, and abuse. The selected candidate will directly... ...identify aberrant billing trends for providers. Facilitate quarterly meetings and... ...the lower level Compliance Specialist II or equivalent. Experience in analytics...FraudWork at officeRemote workShift work
- Investigator II Location: Hybrid1: This role requires associates be in the office 1-... ...fostering collaboration and connectivity, while providing flexibility to support productivity and... ...cases against perpetrators of healthcare fraud in order to recover corporate and client...FraudTemporary workWork at officeLocal area2 days per week1 day per week
$186.49k - $278.88k
...Job Summary Oversees all clinical pharmacology activities related to pre-IND, IND,... ...of clinical pharmacology and studies. Provides input into all phases of drug development... ...Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and...FraudContract workTemporary workLocal areaFlexible hours$74.8k - $130.9k
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$67.64k - $101.46k
Elevance Health is seeking an Investigator II in Atlanta, Georgia, to lead investigations into healthcare fraud. The role combines in-office collaboration 1-2 days a week with remote flexibility. Responsibilities include conducting claim reviews, developing investigations...FraudWork at officeRemote work2 days per week1 day per week
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