SIU Medical & Behavioral Health Coding Investigator
Preferra Insurance
CVS Health is seeking a Certified Professional Coder (CPC) for the Special Investigations Unit to conduct comprehensive medical record reviews ensuring coding accuracy and regulatory compliance. You will prepare written findings and present outcomes to investigators, leadership, and regulators. Requires 3+ years in medical coding with 1–2 years in review/audit, CPC certification, and proficiency in CPT/HCPCS, CMS 1500/UB04. Travel may be needed, full-time position in Florida. #J-18808-Ljbffr Preferra Insurance
- CVS Health Corporation is seeking a Certified Professional Coder (CPC) to join the Special Investigations Unit. The role focuses on medical claim reviews to ensure CPT/HCPCS and revenue codes align with documentation and that state, federal, and company requirements are...Medical
$32.03 - $45.7 per hour
...shifts available Sentara Health Plan is currently... ...Associate Fraud and Abuse Investigator/Certified Professional... ...and hospital based coding in routine desk audits... ...experience required in Medical Coding OR Healthcare (... ...clinical and behavioral health services—all to...MedicalRemote jobHourly payPermanent employmentFull timeTemporary workLive inCurrently hiringShift work$43.89k - $93.57k
...We’re building a world of health around every individual —... ...Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a... ...record review for medical, behavioral, transportation and other...MedicalHourly payFull timeTemporary workLocal area$56.2k - $101k
...million members. Centene is transforming the health of our communities, one person at a time... ...highly preferred. Position Purpose: Investigate allegations of potential healthcare... ...equivalent experience required ~1+ years Medical claim investigation, medical claim audit...MedicalFull timePart timeWork at officeRemote workFlexible hours$46.99k - $112.2k
...Dental Fraud Investigator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience... ...in data analysis and research ~ Knowledge of Medical Terminology Preferred Qualifications Credentials...MedicalHourly payFull timeTemporary workLocal area$62.7k
...responsible for conducting investigations of organizational or... ...Credentialing and/or Medical Review Committee, law... ...experience in the health insurance industry and... ...processing systems and coding and billing proficiency... ...and legal standards and behavioral expectations as set...MedicalContract workFor contractorsWork at officeLocal area- Internal Medicine Physician — Principal Investigator (Training Provided) Alliance Clinical Network... ...Alliance Clinical Network, we advance medical innovation through high-quality, patient... ...make meaningful contributions to human health. #J-18808-Ljbffr Alliance Clinical...MedicalPart timeFor contractorsH1bRemote workFlexible hours
- ...StatesCompany: CVS HealthPosted: 2026-10-12CVS Health Corporation in the United States is... ...(CPC) Manager to oversee a team of medical coders within the SIU, ensuring compliant coding practices through reviews of records across medical, behavioral, transportation, and other...Medical
- Remote Behavioral Health Billing & Claims Specialist 100% Remote Flexible... ...experienced behavioral health medical biller who takes pride in... ...documentation, demographics, coding, credentialing, and payer requirements... ...and denied claims and investigate the cause of nonpayment....MedicalRemote jobFull timeLive inWork at officeWork from homeFlexible hours
- ClinChoice is seeking a Physician Sub-Investigator Consultant for a per-diem 12-month contract at our Miramar, FL site. Required ABIM internal medicine board certification, active Florida medical license, and clean DEA registration. Responsibilities include screening volunteers...MedicalDaily paidContract workWeekend workAfternoon shift
- Job Title: Physician Sub-Investigator Consultant Location: Location: 3340 Enterprise Way, Miramar, FL, 33025 (Temp to permanent.) Assignment... ...) MD with board certification in internal medicine, active FL medical license, unrestricted license Screenings: Basic Background...MedicalDaily paidPermanent employmentContract workTemporary workShift workAfternoon shift
- University of Miami Health System is seeking a faculty member in the Department of Medicine, Division of Medical Oncology, to take on clinical, research, and administrative responsibilities. This role involves serving as an attending physician, providing outpatient care...Medical
- ...job alerts for “Onpoint” roles. Physician Lead - OnPoint Pediatrics at Highlands Ranch Purchasing and Accounts Payable Specialist Medical Assistant Supervisor - Parker Square Physician - OnPoint Pediatrics at Highlands Ranch Medical Assistant Supervisor - Columbine Family...MedicalDay shiftAfternoon shift
- HCA Florida Capital Hospital is seeking a Behavioral Health Registered Nurse to deliver high-quality, patient-centered care within our behavioral health services. You will collaborate with medical providers and a multidisciplinary team to coordinate, evaluate, and personalize...Medical
- New Horizons in Florida is seeking a Behavioral Health Admissions Nurse for Screening Services to perform nursing assessments for clients presenting... ...use concerns. You will monitor vital signs, evaluate medical stability, and coordinate with the multidisciplinary team to...Medical
- Lotus Behavioral Health is seeking an LPN to provide on-site nursing and attendant care for adolescents in a residential behavioral health setting. You will monitor health, administer medications, maintain medical records, and coordinate medical services in alignment with...Medical
- ...seeking a Registered Nurse (RN) to provide comprehensive nursing and case management services for individuals with behavioral health and complex medical needs. The RN will travel between Madison, Jefferson, Taylor, Wakulla, Liberty, and Franklin counties to coordinate...Medical
- ...Centers is seeking a qualified Staff Nurse (RN/ LPN) to provide direct nursing care in our inpatient behavioral health programs. This on-site role in Stuart, FL supports medical providers and interdisciplinary teams to ensure patient safety and regulatory compliance....Medical
- Lotus Behavioral Health is seeking a compassionate LPN for night shifts or weekends to provide on-site nursing care for adolescents in a residential... .... Responsibilities include monitoring health, administering medications, maintaining records, and coordinating medical services...MedicalNight shiftWeekend work
$30.75 - $33 per hour
Infinite Medical P.C. in Hollywood, FL is hiring a Licensed Practical Nurse (LPN) for an LPN Care Coordinator position in a BHI program... ...managed care preferred; strong communication and geriatric behavioral health experience is desirable. #J-18808-Ljbffr MedElite Group, LLC...MedicalHourly payFull timeWork at office- CVS Health is seeking a Behavioral Health Precertification/Utilization Management Clinician to review authorization requests and determine medical necessity for behavioral health services. This fully remote role emphasizes evidence-based care and timely decisions. The...MedicalRemote jobMonday to Friday
- Infinite Medical P.C. is seeking a Licensed Practical Nurse (LPN) to serve as a Behavioral Health Care Manager within our Collaborative Care Model (CoCM) program. This is an in-office, non-face-to-face care management position supporting residents in skilled nursing facilities...MedicalWork at office
- ...compassionate and dedicated LCSW or LMHC to join our growing behavioral health program. This provider will provide therapeutic interventions... ...professional integrity Strong communication skillpss Strong medical decision-making skills Displaying a caring and professional attitude...MedicalMonday to Friday
$50 - $57 per hour
Molina is hiring a 1099 Behavioral Health Physician (MD/DO) to provide non-clinical utilization management services for behavioral health. The... ...availability, is remote, and involves initial and concurrent medical necessity reviews, peer-to-peer reviews, and first- and...MedicalRemote jobHourly pay- ...ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for...MedicalLocal areaNight shiftWeekend work
- ...through interviews with patients and relatives to gather case history, plan and provide nursing care, and collaborate with medical and behavioral health staff to design appropriate treatment plans. Candidates must hold a current RN license (state required) or be eligible...MedicalPart timeCurrently hiringNight shift
- WestCare Foundation is seeking a Behavioral Health Technician supervisor for our Florida program. The role involves supervising technician duties... ...safety within the residential setting. You will assist medical staff, facilitate groups, and document incidents and logs to...Medical
- ...Therapy Provider seeking a dynamic, energetic Board Certified Behavior Analyst (BCBA) to join our team in Miramar, FL. As a result of... ...collaborations with funding sources, community agencies, schools, medical practices, and other therapy providers Qualifications Master’s...MedicalRemote work
- ...Banyan Treatment Centers is seeking a compassionate and dedicated Behavioral Health Technician (BHT) to provide direct support and supervision... ...build rapport, observe behaviors, and support clinical and medical staff through accurate communication and documentation. Position...MedicalFull timeTemporary work
$90k - $110k
...Job Description Position Overview\n Polara Behavioral Health is actively seeking a dedicated and empathetic Licensed Marriage and Family... ...Coordinate care by collaborating with case managers, families, medical personnel, and educational staff to create comprehensive...MedicalRemote jobFull timeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to SIU Medical & Behavioral Health Coding Investigator. Be the first to apply!
- aml investigator Tallahassee, FL
- federal investigator Tallahassee, FL
- research investigator Tallahassee, FL
- surveillance investigator Tallahassee, FL
- senior investigator Tallahassee, FL
- insurance investigator Tallahassee, FL
- employee relations investigator Tallahassee, FL
- case investigator Tallahassee, FL
- defense investigator Tallahassee, FL
- human rights investigator Tallahassee, FL



