Healthcare Claims Examiner - Fraud & Coding Review (FL)
$14 - $26.42 per hourMolina Healthcare of Illinois
Molina Healthcare is looking for a claims processing support specialist based in the Town of Florida, NY. This role involves evaluating claims for accuracy, identifying procedural errors, and managing documentation to support claims resolution. The ideal candidate should have at least 1 year of clerical or customer service experience, along with proficient data entry and research skills. A strong attention to detail and organizational skills are essential for this position. The position offers an hourly competitive pay range of $14 - $26.42, along with a comprehensive benefits package. #J-18808-Ljbffr Molina Healthcare
$25 - $39 per hour
...Research Assistant - Aventura, FL** **Work Setup:** On-site **... ...services, dedicated to driving healthcare forward. We partner with the world... ..., prescreening referrals, reviewing charts from site databases, and... ...policy for candidate fraud. All information and credentials...FraudHourly payFull timePart timeImmediate startWorldwide- ...Enhancement seeks a Sr. Analyst for Fraud, Waste, and Abuse (FWA) specifically in healthcare services. This full-time position involves reviewing claims, investigating potential fraud, and... ...will have 3-5 years of experience, coding certifications, and a strong understanding...FraudFull time
$14.9 - $29.06 per hour
Molina Healthcare in California seeks a Senior Claims Examiner to provide support for claims examination, focusing on evaluating claims for coding errors and fraud. You will manage a caseload and ensure compliance with state and federal regulations while maintaining meticulous...FraudHourly payWork at office- ...billing office is located in Jupiter, FL. Our company vision is not to be... ...AR is clean for month‑end. CPC coding certification is preferred. Prevent insurance fraud by maintaining ethical billing... ...information to strategic plans and reviews; implementing production,...FraudContract workWork at officeMonday to Friday
- ...subject matter expert in medical coding and DRG validation, playing... ...detailed retrospective claims reviews, provide expert-level coding... ...and continuous improvement in healthcare operations. Duties &... ...coding discrepancies, potential fraud, and quality concerns Provide...FraudFull timeWork at officeRemote workWork from homeHome office
$46.99k - $122.4k
..., located in Town of Florida, New York, is seeking a Fraud Investigator with experience in healthcare fraud and abuse investigations. The role involves handling... ...three years of relevant experience, knowledge of coding systems, and a Bachelor's degree. The position offers...FraudFull time$21.82 - $42.55 per hour
Molina Healthcare is seeking candidates for a role focused on investigating medical provider coding fraud, waste, and abuse (FWA). The position requires independent assessment of medical claims, adherence to regulatory standards, and effective communication within teams...FraudHourly pay- ...Specialist with Mindlance Inc . I have reviewed your resume and at a first... ...with our Client based in FL to fill this requirement urgently... ...job: Verify member submitted claims forms, member’s eligibility... ...Analyze claims for potential fraud by member or pharmacy. May be...FraudContract workFor contractorsShift work
$15 - $16 per hour
...Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working... .... Analyze claims for potential fraud by member or pharmacy. May be... ...submitted test claims, and completed or reviewed prior authorizations required....FraudHourly payPermanent employmentTemporary workImmediate startMonday to Friday$24.3 - $36.16 per hour
Coding Specialist (remote position) page is loaded## Coding Specialist... ...a strong position against fraud and abuse* Comply with... ...and co-existing conditions.* Reviews medical staff documentation and... ...Good Shepherd Hospice, Hope Healthcare, Hospice of Okeechobee, HPH Hospice...FraudRemote jobWork experience placementLocal area$40.95k
Overview Description Associate APD Claims Representative — Orlando... ...Boulevard, Suite 160, Orlando, FL 32817 Thank you for considering... ...checks which include a review of criminal, educational, employment... ...job seekers from recruitment fraud. We never request sensitive personal...FraudTemporary workWork at officeImmediate startWork from homeMonday to FridayFlexible hours2 days per week$21.82 - $42.55 per hour
...specific to medical provider coding fraud, waste and abuse (FWA).... ...records following review of post-payment claims. Essential Job Duties Independently... ...(CPCO). Certified Fraud Examiner (CFE) and/or Accredited... ...and Compensation Molina Healthcare offers a competitive...FraudHourly payContract workWork experience placementWork at officeLocal area- Optometrist (Essential Eyecare & Optical) - Apopka & Longwood, FL page is loaded## Optometrist (Essential Eyecare & Optical) - Apopka... ...Fair Chance Act, and any other similar laws.**Notice to Candidates: Fraud Alert - Fake Job Opportunity Solicitations Used to Collect Fees/...FraudFull timePart timePrivate practiceWork at officeLocal areaFlexible hours
$57k
...Overview The Opportunity Underwriter Assistant - Plantation, FL Salary starting at $57,000 per year plus bonus opportunities! Looking... ...An Underwriter Assistant provides support to an Underwriter by reviewing applications, evaluating risk, creating quotes, and processing...Work at office- Molina Healthcare is seeking a Special Investigation Unit investigator to support investigation... ...activities related to health care fraud, waste, and abuse (FWA). This role... ...information to determine allegations, reviews coding and billing guidelines, and contributes...Fraud
- ...Insurance Defense (Hybrid, NY Metro or FL)Applyremote type: Fully Remotelocations... ...discovery and motion practice for attorney review* Handle e-filing in federal courts and... ..., including cases involving insurance fraud and complex claims* Prepare arbitration and trial...FraudHourly payContract workWork at officeRemote workWork from homeWork visa
$54k - $103k
...defined authority limits to manage commercial claims of moderate to high complexity and... ...establishes timely and adequate reserves by reviewing and interpreting policy language and... ...subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of...FraudWork experience placementWork at officeLocal areaFlexible hours- ## Workers’ Compensation Claims Specialist (FL, KY) REMOTE**Job Description:**Creative Risk Solutions (CRS), a proud line of business under... ...increase and promotion opportunities — Annually, employees are reviewed for merit increases and promotion opportunities because we...Remote jobFull time
- ...Full-Time Management Sweetwater, FL, US 5 days ago Requisition ID... ...Control & Treasury Support Review prior‑day bank activity across... ...resolve exceptions to prevent fraud and unauthorized disbursements... ...— ensuring accuracy of coding, approvals, and supporting documentation...FraudDaily paidFull timeContract workImmediate start
- JM Lexus in Margate, FL is seeking a Warranty Administrator for a full-time, on-site role. You will review, prepare, and submit warranty claims, verify repair documentation, and ensure proper coding and compliance with dealership and OEM policies. You will work with service...Full time
- ...investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability and aimed at mitigating expenses for our... ...based upon the case manager's instructions Review all case materials prior to conducting...FraudFlexible hours
$16.5 per hour
...informing management and/or appropriate officials of potential fraud risk.SUPERVISORY RESPONSIBILITIESSupervises employees in the absence... ...be asked to provide personal information about yourself. Please review Hibbett’s Privacy Policy to understand how the information you...FraudHourly payFull time$47k - $78k
...defined authority limits, to manage commercial claims with low to moderate complexity and... ...establishes timely and adequate reserves by reviewing and interpreting policy language,... ...subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of...FraudWork experience placementWork at officeLocal area$21.82 - $42.55 per hour
...related to health care fraud, waste, and abuse (... ...). Responsible for reviewing and analyzing... ...national and local coding and billing guidelines... ...and credentialing, healthcare services, member services, claims, etc.), to gather... ...or Certified Fraud Examiner (CFE). Molina Healthcare...FraudHourly payContract workWork experience placementWork at officeLocal area- ...multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance... ...disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In...FraudWork experience placementImmediate start
- Bristol West Injury Claims Attorney Representative Job Summary Participates in training program... ...and/or salvage potential. Reports theft, fraud, and arson losses as required by state and... ...Spending Accounts Job Location(s): US - FL - Lake Mary, US - KS - Kansas City, US -...FraudFor contractorsTraineeshipWork at officeFlexible hoursShift work
$47k - $78k
...defined authority limits to manage commercial claims of low to moderate complexity and... ...establishes timely and adequate reserves by reviewing and interpreting policy language, estimating... .../salvage opportunities or potential fraud occurrences by evaluating the facts of the...FraudWork experience placementWork at officeLocal areaFlexible hours- ...Hollywood, Florida, United States: Florida City, FL: Jasper, Florida, United States:... ...research services, commercial insights and healthcare intelligence to the life sciences and... ...maintains a zero tolerance policy for candidate fraud. All information and credentials...FraudHourly payDaily paidFull timePart timeWork experience placementImmediate startRemote workWorldwide
$46.99k - $122.4k
...payment of fraudulent claims committed by... ...clinical and legal review. Documents all appropriate... ...as a result of fraud matters. Assists... ...prosecution of healthcare fraud and abuse... ...of CPT/HCPCS/ICD coding Knowledge and understanding... ...Certified Fraud Examiners (CFE), an...FraudHourly payFull timeTemporary workLocal area$46.99k - $112.2k
...time. Position Summary The Sr. Analyst, Fraud, Waste, and Abuse (FWA) will assist in detecting... ..., behavioral, transportation, and other healthcare services. The Sr. Analyst will assist in determining correct coding, review claims, and billing data from all types of...FraudHourly payFull timeTemporary workWork experience placementLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Claims Examiner - Fraud & Coding Review (FL). Be the first to apply!
- insurance claims processor Florida, NY
- claims consultant Florida, NY
- remote medical claims processor Florida, NY
- medical claims analyst Florida, NY
- claims analyst Florida, NY
- claims assistant Florida, NY
- senior claims specialist Florida, NY
- claims assistant workers compensation Florida, NY
- medical insurance claims specialist Florida, NY
- claims specialist remote Florida, NY

