Senior SIU Clinical Investigator - Remote Forensic Auditor
Oscar Health Insurance
Tempe, AZ
- Remote job
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 as upcoding or unbundling. As a clinical SME, you will translate findings into education for Oscar teams and build evidentiary files for potential recovery or referrals. This is a remote role with NYC/Tempe office options. #J-18808-Ljbffr Oscar Health Insurance
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Senior SIU Clinical Investigator - Remote Forensic Auditor in Tempe, AZ vacancy
- ...integrity solutions, is looking for a talented Clinical Coder/Fraud Investigator to join our team. Key Responsibilities Work with SIU Team (Clinical Reviewers, CPCs,... ...Professional and career development initiatives ~ Remote work eligible REMOTE WORK...Remote workFlexible hours
Healthcare Fraud Shield
Chesterfield, MO11 days ago - Healthcare Fraud Shield is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters. You will analyze medical records, abstract CPT/... ...attention to detail and the ability to work independently. Remote work eligibility is available. #J-18808-Ljbffr...Remote job
- Centene Corporation is seeking a seasoned Health Care Fraud Investigator to support a remote SIU team across the continental US. You will guide investigations, develop plans, document findings, and collaborate with regulators and internal counsel to mitigate risks. The...Remote jobSeniorFlexible hours
$68.7k - $123.7k
...Senior Clinical Coding Auditor & Trainer-Remote The Senior Clinical Coding Auditor & Trainer will conduct audits of inpatient coding processes for Fiscal care and assist in development of training and audit tools. Location: The Senior Clinical Coding Auditor & Trainer...Remote jobSeniorFull timePart timeWork at officeFlexible hours$60.2k - $107.4k
...have the flexibility to work remotely as you take on some tough challenges... ...are met Collaborate with clinical coding consultant to apply... ...validity of aberrances (SIU only) Gather all relevant... ...articulate behavior through an Investigation Summary and compliance package...Remote workSeniorMinimum wageFull timeWork experience placementLocal areadivvyDOSE
United States1 day ago- UnitedHealth Group seeks a Clinical Review Clinician to analyze itemized hospital bills and document adjustments for forensic reviews. Telecommute from anywhere in the U.S. The role requires clinical experience, RN or LPN license, and bill review knowledge. You will support...Remote job
- Centene Corporation is seeking a clinical compliance investigations professional to lead enterprise-wide investigations for all business units and health... .... You will collaborate with Legal, People Relations, SIU, Privacy, Finance, and Operations to drive timely remediation...Remote jobSenior
- ...Senior Auditor Employment Type: Full Time, Mid-level CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses...Remote workSeniorFull timeFlexible hours
Contact Government Services LLC
Charlotte, NC2 days ago - ...Blue Cross NC is seeking a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a clinician and coder team dedicated to detecting and preventing... ...The position supports a Hybrid Flex workplace with remote leadership responsibilities and collaboration with...Remote workFlexible hours
Blue Cross and Blue Shield of North Carolina
Topeka, KS1 day ago $70.1k - $126.2k
...million members as a clinical professional on our Medical... ...the VP of Compliance Investigations this position assists... ...Investigations and/or senior management regarding... ...Legal, People Relations, SIU, Privacy, Finance, and... ...approach to work with remote, hybrid, field or...Remote workSeniorFull timePart timeWork at officeFlexible hours$107.9k - $172.64k
...Job Description Blue Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical to lead a team of clinicians and coders focused on detecting... .... Provide engaging, effective leadership for a remote workforce, including coaching, feedback, and...Remote workWork at officeLocal areaFlexible hours2 days per weekBlue Cross and Blue Shield of North Carolina
Lansing, MI11 hours ago$75.35k - $98.89k
...Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the... ...documentation, using forensic clinical expertise to... ...Location: This is a remote position, open to... ...Professional Medical Auditor (CPMA), Certified Fraud...Remote workFull timeWork at officeWork from homeFlexible hours3 days per weekOscar Health
New York, NY3 days ago- Praescient Analytics is looking for a Senior Forensic Accountant to support complex financial investigations, particularly in identifying fraud and abuse in federal programs. The ideal candidate will have extensive experience in forensic accounting, with a strong focus...Remote jobSenior
- Arizona Supreme Court is seeking an Investigator and Compliance Auditor - Specialist V to manage complaints, conduct investigations, and perform audits of certified entities and licensed individuals. The role requires a bachelor’s degree and 3 years’ related experience,...Remote workSeniorTrial period
- ...Senior Forensic Accountant At Ardent, we hire people who want more than a job — they want to serve a mission... ...Forensic Accountant to join our team. This is a remote position supporting complex financial investigations, fraud analysis, and the tracing of illicit financial...Remote workSeniorWork at officeLocal areaFlexible hours
Ardent Services
United States11 hours ago - Location: Remote (Occasional Travel May Be Required) Clearance: Ability to obtain and maintain a Public... ...Praescient Analytics is seeking an experienced Senior Forensic Accountant to support complex financial investigations involving fraud, waste, abuse, and mismanagement...Remote workSeniorWork at office
$150 per hour
...Principal Investigator (MD/DO) Hawthorne Health is seeking an experienced Principal Investigator... ...as a PI or Sub-I on sponsor-initiated clinical trials. This role will lead Respiratory... ...training and oversight. Conduct remote review of patient assessments, including...Remote workContract workPart timeFor contractorsLocal areaFlexible hoursHawthorne Health, Inc.
Lebanon, TN11 hours ago$58.4k - $107.74k
...Clinical Provider Auditor II - Payment Integrity SIU Location: This role enables associates to work virtually full-time, with the exception of required... ...related questions as necessary to aid in investigations and stays abreast of current medical coding and billing...Full timeTemporary workWork experience placementWork at officeLocal area1 day per weekElevance Health
Norfolk, VA4 days ago$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers... ...thorough case information in the Special Investigations Unit's (SIU's) case tracking system Collect and secure documentation...Remote workSeniorMinimum wageFull timeTemporary workWork experience placementLocal areaUnitedHealth Group
United States4 days ago- A growing multi-site clinical research company is seeking a Principal Investigator to lead and coordinate clinical trial activities. The role includes ensuring the... ...plan. The position is full-time and offers a mid-senior level career path with various health benefits. #J...SeniorFull time
- Centene Corporation seeks a seasoned Compliance Investigations leader to guide an enterprise-wide program for investigations across business... ...reports, and collaborate with Legal, People Relations, SIU, Privacy, Finance, and Operations. The role requires strong regulatory...Remote jobSenior
- ...stakeholders that delivers on our promises. Position Summary:The SIU Investigator will conduct field as well as desk investigations of... ...Investigative Unit. Our Special Investigator will function as a remote investigator working from her/his residence and servicing the...Remote workFull timeWork experience placementWork at office
- Travere Therapeutics in San Diego, CA, seeks a Senior Quality Assurance Associate - GMP/GDP Auditing to execute audits, support supplier... ...Technical Operations, Supply Chain, Regulatory Affairs, and Clinical Operations to maintain robust supplier programs and support regulatory...Remote jobSenior
- 1100 Endeavor Health Clinical Operations is seeking a Senior Auditor for Billing Compliance to conduct audits and ensure regulatory adherence. This hybrid role is based in Evanston, Illinois, and requires a Bachelor's degree along with specialized certifications. The ideal...Remote jobSenior
- Travere Therapeutics in San Diego seeks a Senior Quality Assurance Associate to execute GMP/GDP audits and support supplier qualification... ...inspections. The role partners with Quality, Regulatory, and Clinical Operations to drive risk-based auditing, CAPA management, and...Remote jobSenior
$25 - $50 per hour
...support Professional autonomy in case strategy & scheduling Paid travel for field investigations when required Job Summary The SIU Investigator conducts field and remote investigations involving insurance claims. This role requires a strong understanding of...Remote workHourly payPart timeWork at officeHome officeFlexible hoursAfternoon shiftKelley Alliance
Fort Lauderdale, FL4 days ago- ...healthcare fraud prevention is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical... ...ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a...Remote workFull time
Healthcare Fraud Shield
Wildwood, MO1 day ago - Travere Therapeutics is seeking a Senior Quality Assurance Associate to lead GMP/GDP auditing across our external partner network. You... ...with Technical Operations, Supply Chain, Regulatory Affairs, Clinical Operations, and other teams, contributing to risk-based supplier...Remote jobSenior
- Pinnacle Clinical Research- A Summit Solution is seeking a Clinical Research Nurse Practitioner/Physician Associate in Dallas, Texas. This position involves being a sub-investigator on study protocols, responsible for follow-up visits, reviewing labs, and recruiting subjects...Senior
- Capital One in Wilmington, DE is seeking an AML Senior Investigator I to support investigations and other AML processes within the Special Investigations... ...alerts, researching cases, presenting findings to senior leaders, and maintaining SIU operations. #J-18808-Ljbffr Capital OneSenior
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior SIU Clinical Investigator - Remote Forensic Auditor. Be the first to apply!
Related searches
- aml investigator Tempe, AZ
- case investigator Tempe, AZ
- insurance investigator Tempe, AZ
- credit investigator Tempe, AZ
- forensic investigator Tempe, AZ
- employee relations investigator Tempe, AZ
- compliance investigator Tempe, AZ
- corporate security investigator Tempe, AZ
- research investigator Tempe, AZ
- security investigator Tempe, AZ