Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse while working remotely. Key responsibilities Develop leads and assess potential fraud, waste, or abuse corroborated by evidence Conduct end-to-end investigations, including witness interviews, data analytics, and medical record reviews Prepare detailed investigation referrals to regulatory agencies and ensure compliance with applicable regulations Required qualifications At least 2 years of investigative experience in the healthcare industry or equivalent education and experience Proven investigatory skills with knowledge of fraud investigation procedures Understanding of claim billing codes, medical terminology, and healthcare delivery systems Ability to research and interpret regulatory requirements Experience with data analytics to detect fraud, waste, and abuse
...Accenture is a leading partner to the worlds major cloud providers, including AWS, Azure, and Google. Accenture Google Business Group (AGBG) focuses on Cloud... ...technology role (e.g., Cloud Engineer, Solution Architect, Senior Developer, Technology Consultant).Minimum of...
...mission to ensure that every student has access to a rigorous and enriching educational experience. Position Overview The Biology Teacher is responsible for delivering Mystic Valley Regional Charter Schools Biology program for students in Grades 712. Instruction...
...Description JOB QUALIFICATIONS: Must have at least 1+ years of credentialing experience (medical or provider experience accepted) Must be tech savvy with credentialing software and Excel Must have HS Diploma or GED Prior insurance industry knowledge and...
...Welcome to Symbio, a MICHELIN-FAURECIA-STELLANTIS joint-venture working for a cleaner mobility. Our company creates hydrogen systems which are integrated in different types of vehicles. Our US team focuses on the integration of our fuel-cells into heavy & medium duty...
Pay Range: $73,714.00 - $98,285.00Provides seniorlevel, independent oversight and technical expertise in the Real Estate Appraisal Department. Responsible for conducting comprehensive reviews of complex appraisal assignments and ensuring compliance with USPAP, Interagency...