SIU Clinical Coder & Fraud Investigator
MetroPlusHealth
MetroPlusHealth in New York seeks a Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit. The successful candidate will review medical records and claims, conduct audits, and collaborate with the team on suspected fraudulent activities. A minimum of 5 years of relevant experience and AAPC coding certification are required. This role emphasizes strong analytical skills, communication, and integrity in handling sensitive healthcare information. #J-18808-Ljbffr MetroPlusHealth
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$25 - $32 per hour
...Job Description Job Description Come grow with us! Lemieux & Associates, a national leader in the investigative industry, is seeking experienced SIU/Claims Investigators in the Bronx, NY or surrounding area. This is a part-time position. The owners are entrepreneurial...SuggestedPart time- ...These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The SIU Fraud Investigator is responsible for identifying, investigating, and resolving allegations and indicators of fraud, waste, and abuse (FWA)...Suggested
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$32 - $38 per hour
...Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance... ...opportunities for claim investigators, SIU investigators, and surveillance investigators... ...Insurance policies and the components of fraud to determine If claims warrant reporting...Work at officeLocal area- ...Exempt Responsibilities • Responsible for operating the Fraud & Abuse hotline involving the intake of all complaints and... ...Department's case tracking database. • Conduct confidential investigations of all assigned cases: collect support evidence, data analysis...Permanent employmentFull timeWork at office
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...Investigator PositionThe Investigator will be responsible for triaging, investigating and resolving instances of healthcare waste and billing... ...Investigator may also conduct onsite provider claim and/or clinical audits (utilizing appropriate personnel) to gather and analyze...- ...economy within everyone's reach while doing the most important work of your career. About the team What you’ll do As a Payments Fraud Investigator, you’ll play a critical role in safeguarding our financial ecosystem by investigating high-risk accounts and identifying...
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$104.9k - $174.7k
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$70k - $105k
...impact from day one. About the Role Family banking has a distinct fraud profile. Minor cardholders face unauthorized transactions they... ...lifecycle transaction monitoring, and suspicious activity investigation, reporting directly to the Head of Compliance. This is a hands...H1bRemote workVisa sponsorshipWork visaFlexible hours- ...reviewing claims and provider behavior for indications of potential fraud, waste and abuse. Knowledge of Medicare requirements, laws,... ...(SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make...Remote work
- About the role Capitex is hiring Junior Fraud Analysts on a remote, short-term contract to support the Digital Fraud Operations team... ..., high-value or confirmed fraud cases to L2 analysts and investigators in line with escalation protocols. Record clear, accurate case...Contract workTemporary workImmediate startRemote workWork from homeShift workNight shiftRotating shiftAfternoon shift
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