SIU Medical & Behavioral Health Coding Investigator
CVS Health
CVS Health Corporation is seeking a Certified Professional Coder (CPC) to join the Special Investigations Unit. The role focuses on medical claim reviews to ensure CPT/HCPCS and revenue codes align with documentation and that state, federal, and company requirements are met. You will articulate findings to investigators and leadership, identify billing errors or potential fraud, and maintain records. The position requires 3+ years of coding experience, CPC certification, familiarity with CMS #J-18808-Ljbffr CVS Health
$43.89k - $93.57k
...We're building a world of health around every individual... ...Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive... ...review for medical, behavioral, transportation and other...MedicalHourly payFull timeTemporary work$46.99k - $102k
...Senior Investigator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience... ...fraud and abuse matters. ~ Working knowledge of medical coding; CPT, HCPCS, ICD10 ~ Experience with Microsoft...MedicalHourly payFull timeTemporary workWork at officeLocal areaRemote work$46.99k - $112.2k
...We're building a world of health around every individual - shaping a more connected, convenient... ...to effectively pursue the prevention, investigation and prosecution of Fraud, Waste and... ...analysis and research ~ Knowledge of Medical Terminology Preferred Qualifications...MedicalHourly payFull timeTemporary workLocal area$56.2k - $101k
...million members. Centene is transforming the health of our communities, one person at a time... ...highly preferred. Position Purpose: Investigate allegations of potential healthcare... ...equivalent experience required 1+ years Medical claim investigation, medical claim audit...MedicalRemote jobFull timePart timeWork at officeFlexible hours- The Florida Department of Health is seeking a Medical Malpractice Investigator at the Alachua Field Office. The role conducts complex investigations into alleged malpractice within the department's jurisdiction, coordinating with legal counsel and other agencies. The incumbent...MedicalWork at office
- Florida Department of Health seeks a Medical Malpractice Investigator to join the Investigative Services Unit in Alachua, FL. The role handles complex investigations, reviews medical records and complaint documents, and coordinates with legal counsels and agencies to support...Medical
$42.56k - $43.56k
Requisition No: 886889 Agency: Department of Health Working Title: MEDICAL MALPRACTICE INVESTIGATOR - 64085628 Pay Plan: Career Service Position Number: 640856... ...system used by the Agency; knowledge of the laws, legal codes, court procedures and government rules & regulations...MedicalWork at officeLocal areaTrial periodFlexible hours- Remote Behavioral Health Billing & Claims Specialist 100% Remote Flexible... ...experienced behavioral health medical biller who takes pride in... ...documentation, demographics, coding, credentialing, and payer requirements... ...and denied claims and investigate the cause of nonpayment....MedicalRemote jobFull timeLive inWork at officeWork from homeFlexible hours
- ...Families Working Title: Child Protective Investigator Pay Plan: Career Service Position... ...Provider/Worker Therapeutic Assistant Behavioral Health Technician Family Intervention Specialist... ...responder, emergency management or medical professional jobs that occur in high-paced...MedicalWork experience placementWork from homeShift workNight shiftWeekend workAfternoon shift
- ...alert: SENIOR CHILD PROTECTIVE INVESTIGATOR - 60075266 Date: Oct 30, 2026... ...Services, law enforcement, medical personnel, schools, and other... ...degree in social work, behavioral science, criminal justice, nursing... ...integrity maintains loyalty to a code of ethics that requires the...MedicalWork at officeLocal areaMonday to Friday
$65k - $82k
Special Investigations Unit Investigator (Remote) Department: Risk Management and... ...Reporting To: Director of SIU Compensation: $65,000 - $82,000... ...comprehensive benefits package includes: Medical, dental, and vision plans to support your health and that of your family A 401(k...MedicalRemote jobPermanent employmentFull timeTemporary workFor contractorsWork at officeLocal area$25 - $32 per hour
...Job Opening: SIU Field Investigator @ Lemieux & Associates, Tallahassee, FL Pay Range: $25.00 - $32.00/hour, depending on experience Schedule... ...dedicated to delivering professional SIU/DIU, surveillance, and medical canvassing services clients can rely on. Our employees are...MedicalHourly payPart timeFlexible hours- ...Join Sapphire Shores Health and Rehab, a premier healthcare provider... ..., vital signs monitoring, medication administration, IV infusion management... ...in medical records, ICD coding, and billing processes... ...discharge planning, case management, behavioral health interventions,...Medical
- HCA Florida Capital Hospital is seeking a Behavioral Health Registered Nurse to deliver high-quality, patient-centered care within our behavioral health services. You will collaborate with medical providers and a multidisciplinary team to coordinate, evaluate, and personalize...Medical
- ...seeking a Registered Nurse (RN) to provide comprehensive nursing and case management services for individuals with behavioral health and complex medical needs. The RN will travel between Madison, Jefferson, Taylor, Wakulla, Liberty, and Franklin counties to coordinate...Medical
- ...Centers is seeking a qualified Staff Nurse (RN/ LPN) to provide direct nursing care in our inpatient behavioral health programs. This on-site role in Stuart, FL supports medical providers and interdisciplinary teams to ensure patient safety and regulatory compliance....Medical
- ...receive an alert: CHILD PROTECTIVE INVESTIGATOR - 60071457 Date: Sep 10, 2026... ...Intervention Specialist Home Health Aide / CNA Healthcare... ...responder , emergency management or medical professional jobs that occur... ...maintains loyalty to a code of ethics that requires the courage...MedicalWork experience placementWork at officeLocal areaWork from homeMonday to FridayNight shiftWeekend workAfternoon shift
- ...receive an alert: CHILD PROTECTIVE INVESTIGATOR - 60061310 Date: Oct 26, 2026... ...Intervention Specialist Home Health Aide / CNA Healthcare... ...responder , emergency management or medical professional jobs that occur... ...maintains loyalty to a code of ethics that requires the courage...MedicalWork experience placementWork at officeLocal areaWork from homeMonday to FridayShift workNight shiftWeekend workAfternoon shift
$21.53 - $26.91 per hour
...Job Description:** ## **YOU WILL BE:** As an Asset Protection Investigator, you will work as a member of our Asset Protection team to prevent... ...package for all eligible full-time employees (including medical, vision and dental)* An amazing employee discount Benefits: We...MedicalFull timeRemote workFlexible hours- Palms Medical Group (PMG) is a not-for-profit Federally Qualified Health Center serving communities across North Florida. The Licensed Clinical Social Worker will provide behavioral health services including crisis intervention, brief psychotherapy, and care coordination...Medical
- Author Health, LLC is seeking a committed Care Manager (RN) to coordinate comprehensive care for adults with behavioral health needs in a fully remote setting. The role focuses on improving... ...3 years in behavioral health or medical case management, strong EHR proficiency...MedicalRemote job
- ...receive an alert: ADULT PROTECTIVE INVESTIGATOR - 60048301 The State... ...emergency services including medical evaluations, temporary placement... ...Intervention Specialist Home Health Aide Nurse (LPN or RN) or similar... ...maintains loyalty to a code of ethics that requires the courage...MedicalTemporary workWork experience placementWork at officeLocal areaWork from homeMonday to FridayNight shiftWeekend work
- Infinite Medical P.C. is seeking a dedicated Licensed Practical Nurse (LPN) to serve as a Behavioral Health Care Manager within our Collaborative Care Model. This in-office, non-face-to-face care management position supports residents in skilled nursing and long-term care...MedicalWork at office
- Acadia Healthcare's Orlando Behavioral Health in Apopka, FL is seeking a Registered Nurse for a night admissions role. Shift: 7:00 PM-7:30 AM... ...intake assessments, verify benefits, and coordinate with medical and psychiatric staff to ensure appropriate level of care. #J...MedicalShift workNight shiftWeekend work
- ...Full-Time Medical AssistantCome grow with us! Elite DNA Therapy Services is one of the largest providers of behavioral and mental health services in Florida – and we're expanding quickly! We believe... ...RecordsKnowledge of CPT & ICD-10 Coding proceduresKnowledge of medication...MedicalFull timeWork at officeMonday to FridayShift work
- ...Therapy Provider seeking a dynamic, energetic Board Certified Behavior Analyst (BCBA) to join our team in Miramar, FL. As a result of... ...collaborations with funding sources, community agencies, schools, medical practices, and other therapy providers Qualifications Master’s...MedicalRemote work
- ...Treatment Centers in Stuart, FL, invites a compassionate Lead Behavioral Health Technician (BHT) to join our night-shift team. You will... ...crisis management, and ensure safety while coordinating with medical staff. The role emphasizes direct patient interaction, adherence...MedicalNight shift
- Community Care Plan seeks a Behavioral Health Care Coordinator to join the South Florida Care Coordination team. You will work with enrollees, clinicians, and care teams to manage behavioral and medical health across a broad population, including adults and children with...Medical
- ...qualified Staff Nurse (RN/LPN) to deliver direct nursing care in inpatient behavioral health and substance use treatment programs. This per-diem, 12-hour shift role emphasizes patient safety, timely medical intervention, documentation accuracy, and regulatory compliance in a...MedicalDaily paidShift work
$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role... ...certifications, concurrent reviews, and continued-stay reviews . Support medical necessity using ASAM, LOCUS, and CALOCUS criteria. Obtain...MedicalFull timeRemote workMonday to Friday
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