CA Healthcare Fraud Investigator - Data-Driven Claims
$56.2k - $101kCentene
Centene is seeking a Healthcare Fraud Investigator in Palos Verdes Peninsula, CA, responsible for investigating allegations of healthcare fraud and abuse. Candidates will conduct investigations, document findings, and develop reports for referral to regulatory agencies. The position requires a Bachelor's Degree in a related field and offers a salary range between $56,200 and $101,000 annually, with a comprehensive benefits package. Centene values diversity and is an equal opportunity employer. #J-18808-Ljbffr Centene
$112.7k - $193.2k
...of the most complex and highly regulated healthcare markets in the country, where... ...Partner with clinical, network, contracting, claims, compliance, and technology teams Manage... ...recommendations Support strategic decisions with data‑driven insights and structured thinking Key...DataClaimsMinimum wageFull timeWork experience placementLocal area$121k - $129k
...Safety Manager (HSE) - Torrance, CA Pay Range $121,000-$129,000... ...incidents, injury, and near‑miss investigations, including root cause analysis... ...regional HSE performance data, identify trends, and define targeted... ...and workers comp claim management Intermediate / advanced...DataClaimsTemporary workWork at officeLocal area$25 - $32.95 per hour
...seeking a dedicated individual for a position focused on ensuring the financial stability of healthcare services. This role involves entering patient data for billing claims and verifying insurance coverage. The ideal candidate should have at least 1 year of experience...DataClaimsHourly pay$136k - $182k
...healthy society where mental and physical healthcare are unified to make lives better. Our... ...services focused on evidenced-based, medically driven treatment services for children,... ...Health and may represent threats to your data security. LifeStance Health complies...DataFull timeFlexible hours$136k - $182k
...healthy society where mental and physical healthcare are unified to make lives better. Our... ...services focused on evidenced-based, medically driven treatment services for children,... ...Health and may represent threats to your data security. LifeStance Health complies...DataFull timeFlexible hours$117k - $134k
...healthy society where mental and physical healthcare are unified to make lives better. Our... ...services focused on evidenced-based, medically driven treatment services for children,... ...Health and may represent threats to your data security. LifeStance Health complies...DataFull timeFlexible hours$291.5k
...Optum CA is seeking an Obstetrician-Gynecologist to join our team in Northridge, CA. Optum... ...ll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind...DataMinimum wageWork experience placementLocal areaWork from homeMonday to Friday$19.64 - $42.55 per hour
...Job Title Investigative Support For Special Investigation... ...provider coding fraud, waste and abuse (... ...of post-payment claims. Essential Job... ...quantities of data. Ability to... ...Job Board. Molina Healthcare offers a competitive... ...Oceangate, Long Beach, CA, 90802, US...DataClaimsHourly payFull timeContract workWork experience placementWork at officeLocal areaRemote work$117k - $134k
...healthy society where mental and physical healthcare are unified to make lives better. Our... ...services focused on evidenced-based, medically driven treatment services for children,... ...Health and may represent threats to your data security. LifeStance Health complies...DataFull timeFlexible hours$59.81k - $129.59k
...payment integrity (PI) and provider claims accuracy. Makes... ...Applied Analytical Support • Uses data analysis tools/systems to support... ...Classification of Diseases (ICD), Healthcare Common Procedure Coding System... ...200 Oceangate, Long Beach, CA, 90802, US Salary Range $59...DataClaimsFull timeTemporary workWork experience placementWork at office$25 - $32.95 per hour
...ensure financial stability by entering patient data accurately, timely, and efficiently in order to create a claim to bill for medical services provided. Core... ...of Years Experience - Type of Experience 1 - healthcare revenue cycle, medical industry or customer service...DataClaimsNight shiftAfternoon shift- ...working for positive people at AIDS Healthcare Foundation! Does the idea of... ...audit preparation, detailed claim-level review, and coordination... ..., analyzing claim-level data and pharmacy invoices, and auditing... ...Licenses and Certifications: CA pharmacy technician license...DataClaims
$285k - $335k
...John's Community Health (SJCH), we believe healthcare is a human right-not a privilege. For... ...health centers across Southern California, driven by a commitment to equity, compassion, and... ...contributes to national public health data and outcomes through SJCH's deep partnership...DataFull timeH1bLocal areaVisa sponsorshipRelocation packageFlexible hoursAfternoon shift$109.24k - $150.21k
...relations intake, investigations, fact-finding, documentation... ..., managers, healthcare providers, and... ...compensation administration, claim coordination,... ...through data, process recommendations... ...in our Torrance, CA headquarters and... ...fast-paced, mission-driven company. Together,...DataClaimsTemporary workWork at officeRelocation$121.1k - $140.5k
...Ro is a direct-to-patient healthcare company with a mission of helping... ...’re hiring a Senior Clinical Data Analyst to join Ro’s Scientific... ...From substantiating marketing claims to generating real-world... ...and internal strategy with data-driven insights Write and optimize...DataClaimsLocal areaRemote workFlexible hours$180k - $200k
...Director - 11-001 - SC/ Southern CA Divisional Headquarters Job... ...employee relations, and litigation claims. The DHRD ensures that all... ...accuracy and ensure employee data integrity. Manage the workers... ...programs. Extensive knowledge in investigating cases, making recommendations...DataClaimsFull time$35 - $45 per hour
...Trainer Certified PRN Location: US-CA-Gardena Job ID: 342273... ...Workers' Compensation cases through claim capture and follow‑up... ...wellbeing in the workplace Perform data analysis to measure direct and... .... Basic Life Support for Healthcare Providers or equivalent Demonstrated...DataClaimsHourly payDaily paidReliefLocal areaShift work- ...Family Medicine Physician - Long Beach, CA (Full-Time) Job Type: Full-time (On-site) Schedule... ...Physician to join a dynamic, technology-driven healthcare team dedicated to improving patient outcomes through innovative, data-supported care. This is an exciting opportunity...DataFull timeWork at officeMonday to Friday
$45k - $60k
...Benefits division in Torrance, CA. Work in the office every day... ...service for clients including claims, billing eligibility, and service... ...enrollment meetings. Collect forms, data, and schedules for regulatory... ...multi-tasking in a deadline-driven environment. Ability to work...DataClaimsWork at officeWork from homeMonday to FridayFlexible hoursWeekday work$45k - $60k
...day service for clients including claims, billing eligibility, and... ...enrollment meetings Collects forms/data/schedules for regulatory... ...with multi-tasking in a deadline-driven environment Requirements/Preferences: ~ Obtaining CA Life and Health License within 3...DataClaimsWork at officeWork from homeMonday to FridayFlexible hoursWeekday work$18.5 per hour
...Technical Writing Intern job at Dermalogica. Carson, CA. Who We Are Dermalogica stands tall as a beacon in the... ...actives/ingredients affect it. Gather and summarize data from cosmetic clinical trials. Elaborate claim support documents for new launches and update current...DataClaimsHourly payInternshipWork at officeWorldwide$38k - $64k
...Account Representative The Claims (Billing) Specialist / Insurance... ...involved in preparing billing data for agencies Guidehouse works... ..., TX office or El Segundo, CA office and three days from home... ...operations, customer service or healthcare field. What Would Be Nice...DataClaimsTemporary workWork at officeFlexible hours$56.2k - $101k
...California* Position Purpose Investigate allegations of potential healthcare fraud and abuse activity.... ...organizing, and executing claims investigations or audits... ...appropriate party Perform data mining and analysis to... ...: Palos Verdes Peninsula, CA #J-18808-Ljbffr CenteneDataClaimsFull timePart timeWork at officeRemote workFlexible hours- ...Registered Nurse Registred Nurse to perform research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment...DataClaims
- ...Benefits Location: Torrance, CA (Hybrid eligibility after 3 months... ...daily service needs, including claims, billing eligibility, and... ...range of professional documents. Data & Reporting: Creates and interprets... ...of multi‑tasking in a deadline‑driven environment. They must be a...DataClaimsFull timeWork at officeLocal areaRemote workWork from homeMonday to FridayFlexible hours
$24 - $34.02 per hour
...balance to a secondary insurer, if one exists, or submitting the claim for the unpaid balance to the patient. Tracks and reports the... ...in gathering documentation necessary to respond to the initial data requests and any subsequent appeals. Complies and submits for approval...DataClaimsWork at office$200k - $250k
...healthy society where mental and physical healthcare are unified to make lives better. Our... ...services focused on evidenced-based, medically driven treatment services for children,... ...Health and may represent threats to your data security. LifeStance Health complies...DataFull timeWork at officeWork from homeRelocation packageMonday to FridayFlexible hoursWeekend work1 day per week$33.5 - $45.3 per hour
...interactions and offering preventive healthcare services such as immunizations... ...processing of insurance claims to resolve customer issues and... ...in analyzing performance data including pharmacy financial,... ...2976 SEPULVEDA BLVD,TORRANCE,CA,90505-02804-06251-S Full District...DataHourly payPart timeInternshipWork at officeLocal areaShift work- ...Time 991 Knox Street Torrance, CA 90502, USA Description... ...outcomes. Closely manage all claims, develop strong supportive relationships... ...and relevant. Oversee the investigation of all workplace accidents and... ...and monitor store chemical data on CERS (California...DataClaimsFull timeLocal area
$90k - $110k
...We are a team of driven individuals who create... ...office space in El Segundo, CA. Responsibilities:... ...demands, grievances, UI claims, employee's performance... ...compensation reviews, investigations and terminations. Liaise... ...internal alignment and market data research based on...DataClaimsWork at officeLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to CA Healthcare Fraud Investigator - Data-Driven Claims. Be the first to apply!
- data analysis part time Palos Verdes Peninsula, CA
- data Palos Verdes Peninsula, CA
- medical & healthcare Palos Verdes Peninsula, CA
- health service specialist Palos Verdes Peninsula, CA
- health care administrator Palos Verdes Peninsula, CA
- health career services Palos Verdes Peninsula, CA
- health services administrator Palos Verdes Peninsula, CA
- health care driver Palos Verdes Peninsula, CA
- manager healthcare Palos Verdes Peninsula, CA
- healthcare Palos Verdes Peninsula, CA



