Medical Coding & Audit Investigator (CPC)
Hispanic Alliance for Career Enhancement
CVS Health is hiring a Certified Professional Coder (CPC) to perform comprehensive medical record reviews for the Special Investigations Unit. The role ensures accurate CPT/HCPCS coding and proper documentation, in alignment with state and federal guidelines. You will present findings to investigators, plan leadership, and regulators, while identifying potential savings and compliance risks. Qualified candidates have 3+ years in coding or auditing, CPC certification, and proficiency in #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$70.1k - $126.2k
...Provides guidance to team members who investigate and remediate compliance and fraud, waste... ...fraud-related investigations with audit and risk analysis required. 1+ years... ...managed care claims processing systems and medical claims coding preferred preferred. Licenses/...SuggestedFull timePart timeWork at officeRemote workFlexible hours$95k - $120k
About the role AIG is seeking a Fraud Investigations Manager who is fluent in English and Spanish (reading, writing, and speaking) to join... ...consistently meet deadlines.Possess strong analytical skills to identify audit risks, fraud risks, investigative concerns and appropriate...SuggestedFull time$100k - $135k
...this role, you will support the detection, investigation, and mitigation of financial crime risks... ..., findings, and decisions to support audit and regulatory examinations.Assist in the... ...also includes equity, comprehensive medical, vision, and dental coverage, access to...SuggestedPermanent employmentTemporary workWork at office- Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation. You will review medical records to ensure alignment with guidelines and regulations, and identify schemes such...SuggestedRemote jobWork at office
- ...Qlarant is seeking an experienced candidate to ensure integrity in claims processes. This role requires conducting thorough audits/investigations, analyzing data to assess claims validity, and providing recommendations for resolution. You will compile detailed records and...Suggested
$108.6k
...Attorney's Office has an immediate opening for a Forensic Accountant Investigator in its Forensic Accounting and Financial Investigation Bureau.... ...eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in...Work at officeImmediate startMonday to FridayShift work$108.6k - $122.46k
...Description Division/Unit: Forensic Accounting and Financial Investigation Bureau Civil Service Title: Principal Accountant... ...and eight (8) years of satisfactory diversified accounting and auditing experience, at least two (2) years of which must have been in...Work at officeImmediate startMonday to FridayShift work$46.99k - $122.4k
...prepayment environment Investigates to prevent payment of fraudulent... ...abuse investigatory and audits required. Knowledge of CPT/HCPCS/ICD coding Knowledge and... ...certifications such as CPC (AAPC)and/or CCS (AHIMA)... ...for this position include medical, dental, and vision coverage...Hourly payFull timeTemporary workLocal area- This role conducts audits ‘virtually’ , working entirely remotely in any geography. We ❣️love ❣️our auditors! At ISG, we are committed to forming a partnership with our premium auditors that is based on integrity and open, honest communication. We hire the right auditors...Remote work
- About the EXL Insurance Premium Audit Group A leader in the field, EXL can complete all... .... Benefits package that includes medical, dental, vision, disability coverage, and... ...audits of insured’s business. Interviews, investigates, collects, and records information to be...Remote jobHourly payWork at officeWork from homeWorldwide
- A leading insurance auditing firm is seeking a qualified virtual auditor to conduct audits remotely. The ideal candidate will have at least three years of experience in auditing Workers Compensation and General Liability policies, along with strong communication and organizational...Remote job
$50k - $70k
EXL is hiring for their Insurance Premium Audit Team, offering a competitive compensation package between $50K and $70K in total earnings. The role includes remote work options, comprehensive training, and career advancement opportunities. Benefits feature 17 days of paid...Remote job$90k - $142k
...support engagements, providing expertise in financial fraud investigations, damage calculations, and dispute resolution. The role involves... ...Employment type: Full-time Job function: Accounting/Auditing, Finance, and Legal Industries: Legal Services, Accounting, and...Full time$66.96k
...legal support analysts to conduct complex healthcare fraud investigations. The Medicaid program provides health coverage to millions... ...sampling and analysis. Knowledge of healthcare industry and medical coding (CPT, ICD-9/10, DRGs). CPA not required but the position qualifies...Work experience placementWork at officeLocal areaRemote workFlexible hours- ...global consulting firm that is continuing to grow its Financial Investigations practice across the US. Our client is seeking experienced... ...least eight years of relevant investigative, forensic accounting, audit or consulting experience Experience gained with a recognized...
$50k - $70k
EXL Insurance Premium Audit Team is hiring in the United States. This role offers an hourly base rate plus production bonuses, with total first-year earnings targeted at $50K-$70K. The posted range reflects base salary and bonus potential across our national hiring scale...Remote jobHourly payWork from home$90k - $130k
...Identify key documentation requirements and develop practical solutions to support complex claims investigations. Qualifications Minimum 3 years of experience in accounting, auditing, forensic accounting, or a related field. Strong experience reviewing and analyzing...$75.35k - $98.89k
...a Senior Analyst, Special Investigations Unit Clinical Investigator... ...Investigator detects and audits aberrant billing patterns... ...and post-payment reviews of medical records to ensure billed services... ...and necessity of billed CPC, HCPCS, and ICD-10 codes. Bachelor of Science in...Full timeWork at officeRemote workWork from homeFlexible hours3 days per week$62.7k
...responsible for conducting investigations of organizational or... ...of the case. Conduct audits for proactive and... ...Credentialing and/or Medical Review Committee, law... ...Certified Professional Coder (CPC) Certified Outpatient... ...systems and coding and billing proficiency...Contract workFor contractorsWork at officeLocal area$65k - $88.6k
...an experienced Healthcare Investigator to join its industry leading... .... Conducts on-site audits of provider records ensuring... ...Investigative research and medical record reviews CPT code experience Experience with... ...Clinical Certifications, CPC, CCS, CFE, AHFI) Experience...Weekly payFull timeTemporary workFor contractorsApprenticeshipWork experience placementLocal areaRemote workWork from homeHome officeMonday to Friday$120k - $145k
...teammates.ABOUT THE ROLE:We are seeking an experienced BSA/AML Investigator to help detect, prevent, and report financial crimes. As part... ...rewards package at xAI, which also includes equity, comprehensive medical, vision, and dental coverage, access to a 401(k) retirement...Permanent employmentFull timeTemporary workWork at officeLocal areaRemote workWeekend work$81.8k - $143.1k
The Corporate Investigator is an individual contributor responsible for investigating reports of internal theft, vandalism, fraud, suspicious... ...offers comprehensive benefits including health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and...Local areaFlexible hours- ...needed to meet critical deadlines. Assist in execution of requests from internal partners such as Operational Risk, Compliance, and Audit, ensuring timely and accurate data delivery. Present insights and recommendations to senior leadership, influencing opportunities...Full time
$92.7k - $97.85k
...Description JOB TITLE: Equal Opportunity Investigator DEPT/DIV: Department of Diversity & Civil Rights... ...According to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must...Full timeTemporary workPart timeInterim roleLocal areaRemote workWeekend workAfternoon shift1 day per week$18 - $22 per hour
...Corporation is looking for a Loss Prevention Officer in New York, NY. The role involves overseeing security operations, conducting safety audits, and promoting a safe workplace culture. Responsibilities include monitoring CCTV, training employees, and responding to alarms....Hourly payNight shift- ...chain is seeking Asset Protection Associates to ensure secure shopping experiences and protect company assets. The role involves investigating loss events, monitoring for shrinkage, and maintaining a safe environment for customers and employees. Applicants should have at...
- ...A retail grocery cooperative in Pennsylvania seeks a Retail Investigator to ensure the security of its stores. Responsibilities include loss prevention, compliance auditing, and training associates on security practices. The ideal candidate will have at least 3 years...Flexible hours
$95k
...continues to grow stronger every day. In furtherance of this mission, the BXDA seeks experienced and enthusiastic Cold Case Investigator. A dedicated Cold Case Investigator would be able to assist in reviewing and cataloging Homicide and Sexual Assault cases that have...Work at officeWeekend workAfternoon shift- ...Bergdorf Goodman in New York City is seeking an Asset Protection Investigator to prevent and investigate theft, conduct apprehensions, and support inventory integrity. You will develop leads, prepare case reports, and testify in court when required while maintaining a...
$56.2k - $101k
...state of New York are highly preferred. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity.... ...planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud...Full timePart timeWork at officeRemote workFlexible hours
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