Healthcare Billing Investigator
NYC Health + Hospitals
NYC Health + Hospitals/Jacobi is a 457-bed teaching hospital with a focus on medical billing and revenue cycle management. Under supervision, the role conducts investigations to determine eligibility for medical assistance payment programs and assesses patients’ ability to pay, coding data into the billing system and pursuing collections to maximize hospital revenue. The candidate will review patient information, coordinate with Medicaid, Social Security, and other agencies, and assist with #J-18808-Ljbffr NYC Health + Hospitals
- ...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
- ...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
- ...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...SuggestedFull timeWork at officeLocal areaRemote workFlexible hours
- ...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...Suggested
- ...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
- ...EEO Investigator Equal Opportunity / Office of Legal Affairs New York, NY 10041 Duration: 08/31/2026 – 10/24/2026 | 8 Weeks... ...Arrangement: Hybrid — 3 days onsite and 2 days remote; travel to NYC healthcare facilities as needed. Pay Rate: $65/hr. on W2 Required...Work at officeLocal areaRemote workMonday to Friday
- ...Job TitleProvides support for special investigation unit (SIU) activities specific to medical... ...programs. • Understanding of claim billing codes, medical terminology, anatomy, and... ...patterns, and present findings.Molina Healthcare offers a competitive benefits and compensation...Contract workWork at officeLocal areaRemote work
$56.2k - $101k
...Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical... ...claims, medical records, provider billing practices, enrollment information, financial... ..., and trends that may present risks to healthcare programs and recommend appropriate...Full timePart timeH1bWork at officeRemote workFlexible hours$75.35k - $98.89k
...We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our... ...Investigator detects and audits aberrant billing patterns within claims and clinical... ...expertise to protect the integrity of healthcare spend. You will perform comprehensive pre...Full timeWork at officeRemote workWork from homeFlexible hours3 days per week- ...Effectively use computer systems Document patient information clearly and completely in systems. Interact with other departments to complete billing on accounts. Process rejections, denials, and other correspondence in a timely manner. Process pre authorizations, documenting...
- 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
$85k - $105k
...range $85,000.00/yr - $105,000.00/yr Employment Type: Full-Time, Mid-Level Department: Litigation Support 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...Full timeWork experience placementWork at officeLocal area- 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...
- NewYork-Presbyterian is seeking a Diversion Investigator to lead enterprise-wide investigations into insider threats and diversion of hospital assets, including controlled substances. You will drive investigations with research, interviews, data analysis and CCTV review...
- Centene Corporation is seeking a Fraud, Waste, and Abuse Investigator in the United States to conduct investigations by reviewing referrals... ...to support case resolution. The role requires 2+ years in healthcare investigations and a Bachelor's degree. You will prepare...
- 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
- NewYork-Presbyterian seeks a Diversion Investigator to lead enterprise-wide investigations into insider threats and the diversion of hospital assets, including controlled substances. You will perform research, interviews, data analysis, and CCTV review while collaborating...
$53.76k - $85.14k
...or above, the RCS-1 reports directly to an RCS-2, conducting investigative activities as assigned. The incumbent must be able to perform... ...Brooklyn, NY . New York, NY $96,000.00-$132,000.00 2 weeks ago Billing and Collecting Analyst, Bureau of Revenue New York, NY $83,000...Permanent employmentFull timeTraineeshipWork at officeLocal areaRemote workNight shift- Centene Corporation seeks a Fraud, Waste and Abuse Investigator to conduct investigations using referrals, claims data, medical records, interviews, and analytics to identify misconduct and support case resolution. You will document findings, prepare investigative reports...
$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 timePart timeTraineeshipWork at officeLocal areaShift work- ...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...
- 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
- 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
- GDIT is hiring a healthcare claims Investigative Analyst to support CMS, identifying fraud, waste and abuse referrals from HFPP analytics. This remote role is part of a 50-person team dedicated to reducing fraud in healthcare data. The ideal candidate has 8+ years in health...Remote jobWork at office
$60 per hour
A healthcare staffing agency in New York is looking for an experienced Registered Nurse as a Nursing Home Surveyor/Complaint Investigator. This temporary-to-permanent position requires conducting surveys and investigations to ensure regulatory compliance at nursing homes...Permanent employmentTemporary work$3,218 per month
...Services Job Type Travel Offering Non-Clinical Profession Non-Clinical Specialty EEO Investigator Job ID 18946001 Job Title EEO Investigator (000555) Weekly Pay $3218.0 Shift Details...Weekly payShift workDay shift$61 - $72 per hour
...Opportunity Details Full Time EEO Investigator EEO Investigator JOB-10047311 Anticipated Start Date August... ...anti-discrimination laws Must be able to report to various healthcare facilities throughout New York City to provide targeted, timely...Hourly payFull timeContract workTemporary workWork at officeLocal areaShift work
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