Healthcare Billing & Eligibility Investigator
NYC Health + Hospitals
Kings County Hospital Center in New York seeks a detail-oriented investigator-biller to determine eligibility for medical assistance and to maximize revenue through timely billing and collections. Under direct supervision, you will verify demographic and insurance data, coordinate with Medicaid/Medicare, and prepare third-party claims; you will also support referrals to social services and document billing actions in the system. #J-18808-Ljbffr NYC Health + Hospitals
- ...Mental Health Center in the Bronx, part of NYC Health + Hospitals, seeks a payments and eligibility specialist to assess patients’ medical assistance eligibility and coordinate billing. Under supervision, you will interview patients and families, verify income and...Suggested
- ...Health + Hospitals is seeking candidates for a role focused on conducting investigations to determine patient eligibility for medical assistance payment programs. Candidates will also take actions to bill and collect for services, ensuring coding and verification of patient...Suggested
- Lincoln Medical and Mental Health Center is seeking a Billing/Eligibility Investigator to determine patient eligibility for medical assistance payment programs and to support revenue collection for hospital services. The role requires strong interviewing, investigation...Suggested
- ...Conduct field-based investigations related to Medicaid fraud, abuse, or non-compliance, aligned... ...-specific Medicaid rules. Interview healthcare providers, beneficiaries, and witnesses... ...case evidence. Analyze Medicaid claims, billing patterns, and supporting documentation...SuggestedWork at office
$60.2k - $107.4k
Senior Investigator Pharmacy At UnitedHealthcare, we're simplifying the... ...and prevention of healthcare fraud, waste and abuse. The... ...sources to identify aberrant billing practices and patterns, and... ...employment. Benefits are subject to eligibility requirements. At UnitedHealth...SuggestedFull timeTemporary workWork experience placementLocal areaRemote work$75.35k - $98.89k
...hiring a Senior Analyst, Special Investigations Unit Clinical Investigator... ...detects and audits aberrant billing patterns within claims and... ...to protect the integrity of healthcare spend. You will perform... ...,004 per year. You are also eligible for employee benefits, participation...Full timeWork at officeRemote workWork from homeFlexible hours3 days per week- Shields Health Solutions is seeking an Eligibility Specialist (Pharmacy Technician) responsible for conducting benefits investigations and ensuring accurate documentation. Candidates must have a High School Diploma or GED and PTCB certification. This remote role requires...Remote job
$53.76k - $85.14k
...reports directly to an RCS-2, conducting investigative activities as assigned. The incumbent... ...start of employment. Candidates must be eligible for appointment as a New York State... ...NY $96,000.00-$132,000.00 2 weeks ago Billing and Collecting Analyst, Bureau of Revenue...Permanent employmentFull timeTraineeshipWork at officeLocal areaRemote workNight shift- AirPay automates dental insurance verification and revenue cycle workflows for dental practices. We process millions of eligibility and benefit transactions annually, sourcing data from payer portals, EDI pipelines, and direct connections. The role focuses on finding what...
- NYC Health + Hospitals seeks a Billing Investigator to determine eligibility for medical assistance programs and assess patients' ability to pay; you will verify and update demographic and insurance data, perform billings and collections, and help maximize hospital revenue...
- ...Center continues to be a leading healthcare facility whose mission is to... ...direct supervision, conducts investigations in a health care setting to determine the eligibility of applicants for medical assistance... ...the necessary actions to bill and collect for these services...Full timeWork at office
- ...Affirmative Civil Enforcement (ACE) Investigator Employment Type: Full-Time, Experienced... ...actions involving fraud in areas such as healthcare, contracting, and grants, as well as... ...books, ledgers, payrolls, cost reports, billing statements, invoices, correspondence, computer...Full timeWork at officeLocal areaFlexible hours
- ...something bigger than yourself and help transform the future of healthcare , you’ll find your purpose here. Primary Function of Position: As a part of the global Employment Legal team, the Sr. Investigations and Employment Advisory Specialist will be a pivotal member...Local areaWorldwideFlexible hours3 days per week
- ...Centene Corporation is seeking a senior leader to direct SIU analytics, detection, and investigative analytics across healthcare programs. You will work with SIU leadership and enterprise stakeholders to develop proactive analytics, dashboards, and predictive monitoring...
- ...process. Skills: Medical Biller - Experience with billing edits, claim denials, and follow-up activities. Strong... ..., and four (4) years of full-time experience in interviewing, investigation, or a related field, such as credit and collection follow-up or...Permanent employmentFull timeContract workTemporary workPart timeShift work
$85k - $105k
...Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level CGS is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...Full timeWork experience placementWork at officeLocal area$220k - $250k
...Metabolism at NYU Langone Health invites applications for a Clinician-Investigator with demonstrated expertise in clinical trials focused on... ...multidisciplinary teams within an academic health system. Eligibility for appointment at the Assistant, Associate, or Full...Full time- Pride Health is seeking an experienced EEO Investigator to conduct internal investigations involving workplace discrimination and harassment... ...stakeholders, evaluating findings, and traveling to healthcare facilities around New York City as required. #J-18808-Ljbffr...Work at officeLocal area
- Responsibilities Generate new investigations and continue ongoing investigations and civil actions... ...involving fraud in areas such as healthcare, contracting, and grants, as well as other... ..., ledgers, payrolls, cost reports, billing statements, invoices, correspondence, computer...Work at officeLocal area
- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing claims data, and preparing reports. A bachelor's degree and 1+ years in medical claim analysis are essential. Preferred candidates...Remote work
$60k - $87.4k
...This job is responsible for investigating and analyzing complex, multi... ...and analyzing medical notes, bills, and property damage; and (4... ...HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing... ..., and mouse. Employees eligible to work from home also...Contract workWork at officeWork from homeVisa sponsorshipWork visa$17 per hour
..., education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating... ...funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges....Hourly payDaily paidFull timeTraineeshipLocal areaShift work- Centene Corporation, a national leader in diversified healthcare, seeks a seasoned investigator to guide team members, investigate fraud, waste and abuse, and mentor staff. This remote role covers the continental United States and emphasizes compliance with CMS guidelines...Remote job
- A government services contractor is seeking a Healthcare Fraud Investigator to provide legal support on a large Government project. You will analyze data, review financial and legal documents, and support the development of case referrals. Candidates should have a relevant...Full timeFor contractorsWork at office
$220k - $250k
Clinician-Investigator - Diabetes, Obesity, and Clinical Trials The Holman Division of Endocrinology, Diabetes & Metabolism at NYU Langone... ...multidisciplinary teams within an academic health system. Eligibility for appointment at the Assistant, Associate, or Full Professor...Full time- ...safety and data quality. Tomorrow, we will be the place where any healthcare organization can go to build a responsible clinical AI... ...retrospective studies, including designing study objectives, eligibility criteria and study endpoints, ensuring alignment with scientific...Remote workFlexible hours
- A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...
- 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...Remote jobWork at office
$120k - $145k
...teammates.ABOUT THE ROLE:We are seeking an experienced BSA/AML Investigator to help detect, prevent, and report financial crimes. As part... ...8 U.S.C. § 1157, or (iv) Asylee under 8 U.S.C. § 1158, or be eligible to obtain the required authorizations from the U.S. Department...Permanent employmentFull timeTemporary workWork at officeLocal areaRemote workWeekend work$120k - $140k
...The IMA Group is dedicated to advancing healthcare through innovative, patient-focused... ...study participants and determine trial eligibility. Perform physical examinations and study... ...required sponsor training and attend investigator meetings as needed. Maintain accurate...Full timeLocal areaFlexible hoursWeekend work
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