Remote SIU Investigator: Healthcare Coding & Fraud
Healthcare Fraud Shield
A leading company in healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical records, documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a minimum of one year of coding experience. Join a dedicated team committed to preventing healthcare fraud and ensuring payment integrity. #J-18808-Ljbffr
- ...Investigating allegations of potential healthcare fraud and abuse, the full-time SIU Investigator will conduct investigations, perform data... ...detailed reports while working remotely, preferably from Ohio. Key... ...Ability to understand and analyze healthcare claims and coding...Remote workFraudFull time
- ...your job application. Healthcare Fraud Shield will not contact... ...Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES... ...Work with SIU Team (Clinical... ...discuss to make appropriate coding determinations as... ...development initiatives ~ Remote work eligible...Remote workFraudFull timeFlexible hours
$46.99k - $122.4k
...SIU Senior Investigator We're building a world of health around every individual — shaping a more... ..., investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and... ...required. ~ Knowledge of CPT/HCPCS/ICD coding ~ Knowledge and understanding of...Remote workFraudHourly payFull timeTemporary workLocal area$21.82 - $42.55 per hour
Molina Healthcare is looking for a skilled individual to provide investigative support for the special investigation unit (SIU) focused on medical provider coding fraud, waste, and abuse. The suitable candidate will need to independently evaluate medical claims and maintain...FraudHourly pay$56.2k - $101k
...Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations... ...time off plus holidays Flexible approach to work with remote, hybrid, field, or office schedules Additional...Remote workFraudWork at officeFlexible hours$56.2k - $101k
...flexibility. Please note: this is a remote role with preference on... ...residing within Ohio. Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning... ...analyze health care claims and coding required. Pay Range: $56,200.00 -...Remote workFraudFull timePart timeWork at officeFlexible hours$19.64 - $42.55 per hour
...JOB DESCRIPTION Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves... ...the Internal Job Board. Molina Healthcare offers a competitive benefits and...Remote workFraudHourly payContract workWork experience placementWork at officeLocal area- ...Special Investigations Unit (Siu) Desk Investigator At AssuranceAmerica, we are more than a unique... ...investigations involving suspicions of insurance fraud related to the application of... ...standards, and professional codes of conduct to maintain trust and credibility...Remote workFraudContract workWork at officeRelocation package
$46.99k - $112.2k
...Position Summary The Senior Investigator, Aetna Special... ...known or suspected acts of healthcare fraud and abuse. This position will... ...proactive data mining using SIU Tools to identify aberrant billing... ...Working knowledge of medical coding; CPT, HCPCS, ICD10 ~ Proficient...FraudHourly payFull timeTemporary workWork at officeLocal area- ...Investigator II - Carelon Payment Integrity SIU This role requires associates to be in-office 1 - 2 days per week... ...of cases against perpetrators of healthcare fraud in order to recover corporate and... ...Claim reviews for appropriate coding, data mining, entity review, law...FraudWork at officeLocal area2 days per week1 day per week
$68.04k - $118.8k
...Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain... ...to the Fraud Investigators on SIU investigations and issues. Assist... ...medical records assessments, and CPT coding issues. Provide guidance...FraudWork experience placement- The SIU Investigator will conduct field as well as desk investigations of insurance claims referred... ...Special Investigator will function as a remote investigator working from her/his... ...SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement...Remote workFraudWork experience placementWork at office
- ...Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of fraud and abuse and coordinate with law enforcement. You will assemble evidence... ...investigative reports to support adjudication. Remote work is available with minimal travel. Typical hours...Remote workFraud
- ...Humana is seeking a Fraud and Waste Professional to investigate fraudulent and abusive healthcare practices. The role involves coordinating with law enforcement, gathering... ...guidelines. The position may include remote work with minimal travel and requires strong analytical...Remote workFraud
- Centene Corporation is looking for a dedicated investigator to monitor healthcare fraud activities. You will utilize your investigation skills to ensure... ...benefits package and a flexible work environment including remote options. #J-18808-Ljbffr Centene CorporationRemote jobFraudFlexible hours
- Centene Corporation seeks a candidate to investigate allegations of potential healthcare fraud and abuse. This role involves conducting thorough investigations... ...in the field is required. The position offers a remote working option for candidates residing within Ohio and...Remote jobFraud
$49.7k - $88.8k
...Investigator At UnitedHealthcare, we're simplifying the health care experience, creating... ...identification, investigation and prevention of healthcare fraud, waste, and abuse. The Investigator... ...in the Special Investigations Unit's (SIU's) case tracking system Collect and...Remote workFraudMinimum wageFull timeWork experience placementLocal area- Humana Inc. is seeking a Fraud and Waste Professional to conduct investigations of fraudulent and abusive healthcare practices and to coordinate with law enforcement. The role... ...preparing complex investigative reports. This remote position offers 40-hour weeks, possible...Remote jobFraud
- Centene Management Company LLC is seeking candidates for a position dedicated to investigating allegations of healthcare fraud and abuse within the Kentucky Medicaid Program. The ideal applicant will have a Bachelor's Degree in a related field and a minimum of three years...Remote jobFraud
$56.2k - $101k
Centene Management Company LLC is seeking a Fraud Investigator to investigate allegations of healthcare fraud and abuse. The role is remote but prefers candidates from Texas. The investigator will conduct detailed claims investigations, assist with audits, and prepare reports...Remote jobFraud$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care experience,... ...identification, investigation and prevention of healthcare fraud, waste and abuse. The Senior... ...in the Special Investigations Unit's (SIU's) case tracking system Collect and...Remote workFraudMinimum wageFull timeTemporary workWork experience placementLocal area- Centene Corporation in Kansas is looking for a motivated individual to investigate healthcare fraud and abuse allegations. The role involves conducting thorough investigations, analyzing medical claims, and documenting all activities. The ideal candidate will have a Bachelor...Remote jobFraudFlexible hours
- Centene Management Company LLC is seeking a skilled investigator to handle allegations of healthcare fraud and abuse in New York. In this role, you'll plan, organize, and execute claims investigations, utilizing your expertise in data mining and report creation. The ideal...Remote jobFraudFlexible hours
- Centene Corporation is seeking an investigator to tackle healthcare fraud and abuse, essential for transforming health in communities. This remote role requires a bachelor's degree and at least one year of experience in medical claim investigations. You'll conduct thorough...Remote jobFraudFlexible hours
$56.2k - $101k
Centene Management Company LLC is looking for a skilled investigator to focus on potential healthcare fraud and abuse activities. The candidate will analyze claims, conduct investigations, and prepare detailed reports for regulatory agencies. A Bachelor's degree in Business...Remote jobFraudFlexible hours$43 per hour
...has a client that is seeking a SIU Investigator III in Los Angeles, CA. This is a remote position (must live within driving... ...-depth evaluation of potential fraud and abuse cases and develops complex... ...techniques. * 5+ years of healthcare fraud, waste, and abuse (FWA) investigations...Remote workFraudContract workWork at office- Centene Corporation is seeking an investigator in Arkansas to tackle healthcare fraud and abuse activities. The role involves conducting thorough investigations, performing data analysis, and preparing reports for federal and state agencies. The ideal candidate should hold...Remote jobFraudFlexible hours
- Crains Cleveland is seeking an Insurance Fraud Investigator to conduct investigations into suspects of insurance fraud. This role requires strong investigative skills and the ability to work collaboratively with law enforcement. The ideal candidate will be located in the...Remote jobFraudWork from home
- ...Investigator Senior Carelon Payment Integrity is a proud member of the Elevance Health... ...complex cases against perpetrators of healthcare fraud in order to recover corporate and client... ...: Claim reviews for appropriate coding, data mining, entity review, law...FraudTemporary workLocal area1 day per week
- Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI... ...adjudicated DOD background investigation for this position. Veterans,... ..., and reporting of suspected fraud, waste and abuse (FWA) cases... ...of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA)...Remote workFraudContract workFor subcontractorInterim role
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