Remote Prepay Coding Investigator
Texas Health Institute
- Remote job
Optum, a leader in health care technology and services, seeks a Coding Consultant to investigate and resolve healthcare fraud and coding issues. The role uses CPT guidance to support investigations, mentor teammates, and collaborate with internal and external stakeholders across projects. You’ll work from anywhere in the U.S. with flexible telecommuting, aiming to meet targets and regulatory requirements while contributing to client success and care equity. #J-18808-Ljbffr Texas Health Institute
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud, audit CPT coding, and provide guidance to investigators. The role supports internal and external projects, mentoring colleagues, and ensuring regulatory compliance. The position...Remote job
- Optum is seeking a Coding Consultant to investigate and resolve healthcare fraud and abuse, using CPT coding knowledge to document findings and guide investigations. The role offers telecommuting from anywhere in the United States and targets 8:00am-5:00pm hours with occasional...Remote job
- UnitedHealth Group is seeking a Coding Consultant to investigate and resolve healthcare fraud and provider abuse using CPT coding guidance. You will mentor investigators, review claims against medical records, and coordinate with internal and external stakeholders to ensure...Remote job
- ...review of healthcare claims and documentation, the full-time remote Healthcare Investigator will conduct detailed audits to identify fraud, waste, and... ...and billing records Working knowledge of healthcare coding, billing practices, and medical necessity criteria Understanding...Remote workFull time
- ...is seeking a talented Coder or Clinical Coder/Fraud Investigator. This full-time role involves analyzing patient medical... ..., documenting findings, and ensuring compliance with coding guidelines. The position is remote work eligible, requiring a CPC certification and a...Remote workFull time
- ...Location: Franklin, TN corporate office with remote work flexibility Travel: Up to 25% The Compliance Investigator is responsible for conducting and overseeing prompt... ...regulatory compliance Billing and coding concerns Fraud, waste, and abuse risks HIPAA...Remote workWork at office
$56.2k - $101k
...workplace flexibility. Please note: this is a remote role with preference on candidates residing within Ohio. Position Purpose: Investigate allegations of potential healthcare fraud... ...and analyze health care claims and coding required. Pay Range: $56,200.00 - $101...Remote workFull timePart timeWork at officeFlexible hours- ...Job Title Provides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Essential Job Duties • Independently re-evaluates medical claims and associated records by applying knowledge of advanced...Remote workContract workWork at officeLocal area
$19.64 - $42.55 per hour
...JOB DESCRIPTION Job Summary Provides investigative support for special investigation unit (SIU) activities. Responsible for supporting... ...appropriateness of care, and recognizing and adhering to national and local coding and billing guidelines in order to maintain coding accuracy...Remote workHourly payContract workWork experience placementWork at officeLocal area$21.82 - $51.06 per hour
...JOB DESCRIPTION Provides support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational...Remote workHourly payContract workWork experience placementWork at officeLocal area$64k - $68k
...We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN... ...a favorably adjudicated DOD background investigation for this position. Veterans, Reservists... ...CPT4, ICD-10-CM, HCPCS, DRG and Revenue Code coding conventions. Knowledge of...Remote workContract workTemporary workFor subcontractorInterim roleLocal areaShift work- ...talented Coder or Clinical Coder/Fraud Investigator to join our team. RESPONSIBILITIES... ...in research, discuss to make appropriate coding determinations as needed) Analyze and... ...and career development initiatives ~ Remote work eligible REMOTE WORK REQUIREMENTS...Remote workFull timeFlexible hours
$60.2k - $107.4k
..., you will have the flexibility to work remotely as you take on some tough challenges.... ...requirements are met Collaborate with clinical coding consultant to apply knowledge of coding... ...facts to articulate behavior through an Investigation Summary and compliance package....Remote workMinimum wageFull timeWork experience placementLocal area$25.6 - $42.67 per hour
...Sentara Health Plan is currently hiring a Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote!Status: Full-time, permanent position (40 hours)Work... ...pharmacy, physician, ancillary and hospital-based coding in routine desk audits as well as occasional on-site...Remote workPermanent employmentFull timeTemporary workLive inCurrently hiringShift work$62.7k
...Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged... ...provider facility payment methodology, claims processing systems and coding and billing proficiency Must have understanding of...Remote workContract workFor contractorsWork at officeLocal area- ...Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data... ...fraud patterns Knowledge of healthcare coding, billing, and documentation standards...Remote workFull time
- ...Investigator Position For more than 165 years, the Office of the Indiana Attorney General (OAG) has been committed to serving the best... ...experience. Working knowledge of health care operations, billing, coding and documentation guidelines is preferred but not required....Remote workFull timeWork at officeNight shift
- Healthcare Fraud Shield is seeking a CPC-certified Medical Coding Specialist to join our SIU team. You will review medical records, abstract... ...in reports, and provide subject matter expertise for clients. Remote work eligible; 401(k), generous PTO, and professional...Remote job
$55.9k - $123.5k
...responsible for auditing clinical, billing, coding and lowest cost setting reviews for... ...of findings and consulting with special investigation and the affordability of care area as needed... ...Coding Certification #LI-MW2 #LI-Remote Compensation: $55,900.00 - $123,500.00...Remote workWork from home- ...Shield is seeking a Clinical Coder/Fraud Investigator to join our SIU team at headquarters.... ...medical records, abstract CPT/HCPCS/ICD-10 codes, and prepare reports while maintaining... ...and the ability to work independently. Remote work eligibility is available. #J-18808...Remote job
- ...professional to review clinical, billing, coding, and cost-setting reviews pre- and post-... ...thoroughly, and consult with special investigations and affordability teams as needed. The role... ...(or plan to obtain) are required, with remote-friendly #J-18808-Ljbffr Human...Remote job
- ...Medical Coding SpecialistOptum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits,...Remote workMinimum wageFull timeWork experience placementLocal areaMonday to FridayWeekend work
$107.9k - $172.64k
...Cross NC is hiring a Special Investigations Unit (SIU) Manager of Audit/Clinical... ..., effective leadership for a remote workforce, including coaching... ...requirements, including the Code of Conduct, Compliance... ...processes and workflows for prepayment and post-payment medical record...Remote workWork at officeLocal areaFlexible hours2 days per week$65k - $75k
...and elicit relevant information during investigations. Ability to think critically and adapt... ...Environment Hybrid, 3 days in office, 2 days remote What You Need To Know CIBC is... ...other skills test (such as simulation, coding, French proficiency). We use artificial...Remote workWork at office- A leading financial services company is seeking an AML Sr. Investigator I to support critical anti-money laundering processes. Responsibilities include reviewing alerts, conducting investigations, and preparing reports on suspicious activities. Candidates should have a...Remote workWork from home
- ...ultimate goal of enabling human life on Mars.SR. HUMAN RESOURCES INVESTIGATOR (EMPLOYEE RELATIONS)We are looking for a skilled and... ...to various SpaceX sites.This role requires you to be onsite. Remote or hybrid work will NOT be considered.Must be willing to work...Remote workPermanent employmentWeekend work
- A technology firm is seeking a Corporate Security Investigator to join their Counterintelligence & Threat Management Program. The role offers the opportunity to work remotely and involves managing complex investigations, producing detailed reports, and conducting extensive...Remote work
- ...the University of Michigan in Ann Arbor is seeking a Research Investigator. This is a one year term-limited position with possibility of... ...Modes of WorkPositions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work...Remote work
- .../hr *Dependent upon relevant experience, certification, and education.]]Location: [[Onsite in Springfield, MO (no capabilities for remote or hybrid work)]]Reports to: [[Clinical Research Manager]][[Benefits: Our benefits package for full-time employees includes health...Remote workFull timeLocal areaMonday to FridayFlexible hours
$107.7k - $199.3k
...managing the most complex, sensitive, and high-impact internal investigations across the organization. Serves as a strategic advisor and... ...time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted...Remote workFull timePart timeWork at officeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Prepay Coding Investigator. Be the first to apply!
- aml investigator Minneapolis, MN
- federal investigator Minneapolis, MN
- case investigator Minneapolis, MN
- insurance investigator Minneapolis, MN
- credit investigator Minneapolis, MN
- forensic investigator Minneapolis, MN
- employee relations investigator Minneapolis, MN
- compliance investigator Minneapolis, MN
- corporate security investigator Minneapolis, MN
- background investigator Minneapolis, MN

