Remote SIU Analyst - Healthcare Fraud & Claims Review
Healthcare Fraud Shield
- Remote job
Healthcare Fraud Shield is seeking an SIU Analyst to join the SIU team at our headquarters. This full-time position involves assisting with daily tasks, intake triage, and analysis of medical records for fraud, waste, and abuse investigations. You will support documentation, reporting, and coding extraction while keeping up-to-date with coding guidelines and privacy standards. Remote work eligibility is available along with comprehensive benefits. #J-18808-Ljbffr Healthcare Fraud Shield
- SIU Analyst Department: SIU Employment Type: Full Time... ...Description Healthcare Fraud Shield, a leader in healthcare... ...(Managers, Clinical Reviewers, CPCs, Investigators,... ...of medical records to claim information to... ...development initiatives Remote work eligible REMOTE...Remote workClaimsFraudFull timeFlexible hours
$43.89k - $93.57k
...Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding... ...behavioral, transportation and other healthcare providers. The CPC must have the... ...billing errors, abuse, and fraud. Identify opportunities for savings...ClaimsFraudHourly payFull timeTemporary work- ...SIU Investigator Department: SIU Employment... ...Description Healthcare Fraud Shield, a leader in... ...SIU Team (Clinical Reviewers, CPCs, Investigators, Analysts-including... ...information submitted on the claims in order to... ...development initiatives ~ Remote work eligible...Remote workClaimsFraudFull timeFlexible hours
- Peraton is seeking a Medical Review Analyst for SafeGuard Services. You will conduct medical record reviews and apply clinical judgment to determine claim payments, supporting fraud detection and investigations. Responsibilities include researching regulations, identifying...Remote jobClaimsFraud
$43.89k - $85.07k
...Position Summary The Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative... ...contributor to the SIU lead development... ...reimbursement trends. Review provider billing history...ClaimsFraudHourly payFull timeTemporary workLocal area- ...Medicare Program Integrity Analyst II for a REMOTE role based in Grove City... ...to verify potential fraud and determine appropriate... ...our mission to improve healthcare delivery. You will conduct independent reviews, analyze Medicare/Medicaid claims data, and develop fraud...Remote jobClaimsFraud
$70k - $77k
...Medicare Program Integrity Analyst II - REMOTE The Medicaid/Medicare... ...of potential fraud. Recommends and/or implements... ...to improved healthcare delivery by identifying... ...Conduct independent reviews resulting from the discovery... ...and Medicaid claims data, and proactively...Remote workClaimsFraudFull timeFor contractorsH2bH1bWork at officeLocal areaHome office$60k - $87.4k
...facts behind complex insurance claims. As an SIU Field Investigator, you’ll... ..., identify potential fraud indicators, and gather the information... ...multiple SIU systems Reviews investigations with fraud outcomes... ...HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star...Remote workClaimsFraudContract workWork at officeWork from homeVisa sponsorshipWork visa$64.83k - $94.55k
...We're hiring a Senior Analyst, SIU Investigator to join our... ...behavior observed in claims and enrollment data.... ...process improvements for Fraud Waste and Abuse (FWA)... ...position is fully remote and open to candidates... ...Examiner (CFE), Accredited Healthcare Fraud Investigator (...Remote workClaimsFraudFull timeWork from homeHome office- ...Medicaid/Medicare Program Integrity Analyst II to evaluate leads, complaints,... ...work onsite in Grove City, OH or remotely from a home office. Responsibilities include reviewing claims data, detecting fraudulent patterns, and developing fraud alerts for CMS and state agencies...Remote jobClaimsFraudHome office
$64.23k - $85.1k
...Member Services Data Analyst to support the the... ...in Business, Healthcare Administration, Analytics... ...processes, claims, eligibility, customer... ...Options: Remote Work Location:... ...available. We regularly review our Total Rewards... ...against identity fraud. You are expected...Remote workClaimsFraudFull timeTemporary workImmediate startWorldwideFlexible hours$112.84k - $143.75k
...into action as a Sr. Healthcare Data Analyst at GDIT. Your work will... ...detect and prevent fraud, waste, or abuse across... ...and in-depth claims analysis. Present... ...Telecommuting Options: Remote Work Location: Any... ...available. We regularly review our Total Rewards package...Remote workClaimsFraudTemporary workImmediate startWorldwideFlexible hours$47.5k - $118.8k
...meaningful impact on healthcare. You’ll... ...Business Process Analyst , in this role you... ...terms of contracts . Review and analyze contracts... ...resolve chargeback claims and ensure accurate... ...eligible for this remote position, you must... ...policy for candidate fraud. All information...Remote workClaimsFraudFull timeContract workPart timeWork experience placementImmediate startWorldwide$79.56k - $115.72k
...researchers, and systems analysts to advance our... ...to be within the healthcare industry. As a... ...wasteful, or abusive claim submissions. In... ...and social media reviews. The analyst will... ...investigations of suspected fraud, waste & abuse (... ...0 PM Eastern Time Remote workspace...Remote workClaimsFraudFull timeContract workWork at officeLocal areaMonday to FridayFlexible hoursShift work$58k - $75k
...performing first-level clinical reviews of dental claims and pre-treatment estimates... ...trends, potential fraud, waste, or abuse concerns,... ...practice or comparable dental healthcare setting. Dental claims review... ...managed care setting. #LI-remote Salary range: $58,000 -...Remote workClaimsFraudFull timeContract workInternshipPrivate practiceShift work$36.84k - $52.58k
...researchers, and systems analysts to advance our... ...to be within the healthcare industry. As a... ...Responsible for evaluating claims submitted by... ...Functions -Review and assess medical... ...errors, or potential fraud. -Analyze and validate... ...is eligible for remote work from approved...Remote workClaimsFraudHourly payFull timeWork at officeMonday to FridayFlexible hoursShift work- ...Bill and Medical Record Reviewer job at Alaffia Health.... ...Mission Each year, the U.S. healthcare system suffers from... ...due to medical billing fraud, waste, and... ...have experience reviewing claim forms and auditing provider... ...access to Leadership LI-REMOTE #J-18808-Ljbffr Alaffia...Remote workClaimsFraudFlexible hours
$77.6k - $176k
...and public sectors—from fraud detection to cancer research... ...a highly skilled data analyst with deep expertise in healthcare claims data, Medicare Part A/B/... ...on our Careers site and reviewing Our Employee Benefits... ...cameras on during meetings.Remote: If this position is...Remote workClaimsFraudFull timeContract workPart timeLocal area- Back Registered Nurse - Review Analyst | Remote | Contract Business & Care Management Detroit , Michigan... ...without direct patient interaction or claims review. What We Offer: Competitive... ...precision, expertise, and integrity in the healthcare consulting community! As a certified...Remote jobClaimsWeekly payContract workWork at officeImmediate startWork from homeMonday to Friday
$78.56k - $110.91k
...glance** **Location:** Remote **Facility:** Ascension... ...impact in this role** + Reviews admissions and service... ...precertification, reimbursement and claim denials/appeals. +... ...planning needs with healthcare team members. + May... ...(Spanish) ( poster. **Fraud prevention notice** Prospective...Remote workClaimsFraudFull timeLocal area- Peraton SafeGuard Services seeks a Medical Reviewer to support Medicare fraud detection and payment determinations. The role focuses on reviewing medical... ...and medical necessity. The position involves research on claims data, reviewing data-model outputs, and using diverse...Remote workClaimsFraud
- ...start here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...skills of this position. Recruitment Fraud Alert We are aware of phishing scams... ...If you receive a suspicious message claiming to be from Medtronic, do not respond, click...Remote workClaimsFraudTemporary workImmediate startFlexible hours
$84.34k
Remote Health Insurance QA Analyst Introduction Join a forward-thinking health... ...efficient claims processing, streamlining... ...align with evolving healthcare regulations. This is... ...workshops and process reviews to align QA practices... ...transparency, reduce fraud, and enhance patient...Remote jobClaimsFraudWork from homeHome officeFlexible hours- Seeking Registered Nurse for fully remote role to perform complex medical record and claim reviews for various services and... ...monitor for potential indicators of fraud, waste, and abuse. Provides... ...Medicare, Medicaid, and local healthcare regulations and policies.Self-motivated...Remote workClaimsFraudContract workWork at officeLocal area
$75.58k - $93.37k
...Position Summary The SIU Investigator looks into suspected fraud, waste and abuse (FWA) by... ...analysis, medical record review, interviews, overpayment... ..., internal departments (Claims, Compliance, Payment... ...pay equity, Martin’s Point Healthcare has established defined salary...Remote workClaimsFraudFull timeFor contractorsWork at officeLocal area$51k - $82k
...performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a... ...and to apply sound clinical judgment to claim payment decisions. Responsibilities may include...Remote workClaimsFraudFull timeContract workTemporary workShift workNight shift- .... With human-centered, healthcare-relevant, and value-based... ...Requirements The Nurse Reviewer performs complex... ...Medicare Part A/B and DMEPOS claims that require clinical... ...potential for overpayment or fraud. Using established... ...essential functions. This is a remote position. While...Remote workClaimsFraudContract workFor contractorsLocal area
- Crossing Hurdles is seeking a Senior Claims Investigation and Evidence Review Expert on a contract basis in a remote capacity. The role offers... ...of digital evidence and fraud patterns. You will reconstruct... ...prepare formal assessments for SIU investigators or forensic engineers...Remote jobClaimsFraudHourly payContract work10 hours per week
$62.1k - $105.3k
...based special investigative unit (SIU) investigator with National... ...Arkansas. Investigates suspected fraud on auto, home and specialty claims through scene visits, recorded statements, record reviews and witness interviews. Location: Remote (Arkansas) Pay (as posted):...Remote workClaimsFraudFull time- ...Centene Corp. is hiring a SIU Investigator to conduct fraud, waste, and abuse investigations remotely in Texas. You will review referrals, claims data, medical records, and provider information... .... The role requires 2+ years in healthcare investigations, a bachelor's...Remote workClaimsFraud
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