Clinical Fraud Audit Specialist - Remote Arizona
Healthcare Support
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- ...NC is seeking a strategic SIU Manager of Audit/Clinical to lead a team of clinicians and coders... ..., preventing, and correcting healthcare fraud, waste, and abuse. The role guides prepayment... ...investigations. The position offers remote leadership for a hybrid workforce,...Remote workFraud
- Blue Cross NC is seeking an SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting health care fraud, waste, and abuse. The role emphasizes... ...clinical perspective and leadership in a hybrid/remote setting are essential for success in this...Remote jobFraud
- ...Special Investigations Unit (SIU) Manager of Audit/Clinical to guide a team of clinicians and coders... ...detecting, preventing, and correcting fraud, waste, and abuse. The role supports... ...The position emphasizes leadership of a remote workforce, leveraging AI/tools to improve...Remote jobFraud
- Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting, preventing, and correcting health care fraud, waste, and abuse. This role ensures patient care is accurately documented and...Remote jobFraud
- Blue Cross NC is seeking an SIU Manager of Audit/Clinical to lead clinicians and coders in detecting and preventing health care fraud, waste, and abuse while ensuring accurate documentation... ...and billing. You will manage a remote workforce, develop strategies with internal...Remote workFraud
- ...Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders... ...preventing, and correcting health care fraud, waste, and abuse. You will ensure... ...senior role requires strong leadership for a remote workforce, collaboration with regulators...Remote workFraud
- Blue Cross NC seeks a SIU Manager of Audit/Clinical to lead a team of clinicians and coders focused... ...preventing, and correcting health care fraud, waste, and abuse. You will ensure... ...documentation and billing while guiding a remote workforce and collaborating with regulators...Remote workFraud
- ...Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders... ..., preventing, and correcting healthcare fraud, waste, and abuse. This role ensures... ...SIU's mission. The position emphasizes remote leadership, collaboration with internal...Remote workFraud
- ...Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders... ..., preventing, and correcting healthcare fraud. You will guide strategy, ensure... ...stakeholders. This role supports a Hybrid-Flex/Remote Flex work model with national (US)...Remote jobFraudFlexible hours
$107.9k - $172.64k
...Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders... ...preventing, and correcting health care fraud, waste, and abuse. This role ensures... ...Provide engaging, effective leadership for a remote workforce, including coaching, feedback,...Remote workFraudWork at officeLocal areaFlexible hours2 days per week$75.35k - $98.89k
...Special Investigations Unit Clinical Investigator to join... ...detects and audits aberrant billing patterns... ...Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois... ...Auditor (CPMA), Certified Fraud Examiner (CFE),...Remote workFraudFull timeWork at officeWork from homeFlexible hours3 days per week- Healthcare Fraud Shield is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters. You will analyze medical records, abstract... ...to detail and the ability to work independently. Remote work eligibility is available. #J-18808-Ljbffr HcfraudshieldRemote jobFraud
- Optum Insight is seeking a Clinical Claim Review RN to perform compliance... ...documentation to identify fraud or wasteful practices. The role involves site visits, desk audits, and collaboration with a team... ...full-time (40 hours/week) with remote work options in Massachusetts...Remote jobFraudFull timeLocal area
- Centene is seeking a Manager, Clinical Review for a remote leadership role within Healthcare Integrity. You will lead a team of clinical investigators, oversee complex Fraud, Waste & Abuse cases, and apply your clinical expertise across multiple markets to identify trends...Remote jobFraud
- ...healthcare for the better. Are you a licensed clinical psychologist looking to launch a private... ...you see your patients in-person or remotely via telehealth while working from home.... ...yourself against phishing and recruitment fraud, please note that Headway only accepts applications...Remote workFraudPrivate practiceWork from homeFlexible hours
- ...Clinical Risk Manager 1 in 4 people in the US have a treatable mental health condition, but most providers don't accept insurance, making... ...: To protect yourself against phishing and recruitment fraud, please note that Headway only accepts applications through our...Remote workFraud
- ...Detail-oriented and analytical, the full-time Clinical Audit Response Specialist will support accurate and compliant responses to payer audits and appeals while collaborating with cross-functional teams in a hybrid work environment based in Portsmouth, NH. Key responsibilities...Remote workFull timeWork at office
- First Coast Service Options is seeking a Clinical Review Nurse to evaluate medical necessity, coverage, and payment levels for Medicare... ...claim data and medical records, identify overpayments or potential fraud, and may provide guidance to team members. Strong communication...Remote jobFraud
$75k - $95k
...Licensed Clinical Social Worker Remote Daymark Health is a value-based oncology company redefining the cancer care experience for patients,... ...Fund, and Healthcare Foundry. Be cautious of recruitment fraud, and always confirm that communications are coming from...Remote workFraudWork experience placementImmediate start- ...Inbound Patient Care Coordinators in the Clinical Department. Key responsibilities include... ...agents are compliant with HIPAA and Medicare Fraud, Waste and Abuse rules and regulations at... ...supervisor/management experience in a remote contact center ~ Proficient in Excel...Remote workFraudFlexible hours
- ...LOCATION: Remote - This is a home based, virtual position that operates Monday... ...Conduct prepayment and post-payment audits of DRG coding and clinical documentation. The ideal candidate will... ...compliance and effectiveness in addressing fraud prevention. Additionally, the Complex...Remote workFraudLive inWork from homeMonday to Friday
- ...Revenue Protection Specialist Reporting to the Director of Patient Financial Services,... ...for managing and responding to external audits from government and commercial insurance... ...Institute's revenue. This role requires a clinical background to ensure clinical accuracy and...Remote work
$95k - $125k
...than 500,000 patients worldwide. The Clinical Field Specialist, CT is responsible for optimizing customers... ...for improvement. This is a remote position with up to 80% travel. Ability... ...referrals.Heartflow has become aware of a fraud where unknown entities are posing as Heartflow...Remote workFraudWork experience placementLocal areaWorldwideRelocation$84k - $112k
Description: Clinical Audit Response Specialist Hybrid / Full Time / Portsmouth, NH At Novocure, we're working to extend the lives of patients... ...Response and based in Portsmouth, NH. * Hybrid or remote work expectations may vary based on business needs. * Attendance...Remote workFull timeWork at officeLocal area- ...Job Title Resonsible China Clinical Pharmacology strategy (including intensive PK, popPK... ...click here to learn more: Recruitment Fraud Alert We have recently become aware of... ...-based but can occasionally be performed remotely. Employees who are site/office-based and...Remote workFraudWork at officeLocal areaImmediate startMonday to Friday
$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization... ...Attraction and Branding Specialist Lead @ BroadPath | Employee Training... ...potential quality issues, fraud, or abuse concerns... ...Nurse- Prior Authorization Remote Registered Nurse (Remote Patient...Remote workFraudFull timeWork at officeWork from homeNight shift$125k - $140k
...technology for scale. We're building the technology and clinical services platform to make preventive, connected healthcare accessible... ...in the lives of people, apply today! Beware of recruitment fraud and scams that involve fictitious job descriptions followed by...Remote jobFraudWork from home- Clinical Trial Rater - Borderline Personality Disorder (BPD)Location: Remote based in the USHours: Approximately 5h per weekRole: Clinical SpecialistStart: immediateContract... ...a zero tolerance policy for candidate fraud. All information and credentials submitted in...Remote workFraudFull timePart timeImmediate startWorldwideFlexible hours
$85k - $95k
...Bilingual Licensed Clinical Social Worker, Remote, Arizona Arizona, United States Ascend Healthcare is committed to providing fully integrated, quality psychiatric and behavioral health services in a compassionate, convenient, and affordable manner. We work with...Remote workFull timeWork at officeWork from home$73.4k - $183.6k
...daily collection and billing KPIs audit to maintain updated knowledge... ...(3 days in office, 2 remote) Experience / Qualifications5+... ...a leading global provider of clinical research services, commercial... ...tolerance policy for candidate fraud. All information and credentials...Remote workFraudFull timePart timeInterim roleWork at officeImmediate startWorldwide
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