- Molina Healthcare (Owensboro, KY)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by ... GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years...5+ years of experience working in a FWA / SIU or Fraud investigations role for New… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit ( SIU ) Investigator is responsible for supporting the prevention, detection, ... also include coding and billing reviews. The SIU Investigator is responsible for reviewing and...assessments of FWA allegations, and end to end full investigations , including but not limited to witness interviews, background… more
- Centene Corporation (Oklahoma City, OK)
- …and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud ... and abuse. + Conduct investigations of potential waste, abuse, and fraud + Document...referral to Federal and State agencies + Complete various special projects and audits **Education/Experience:** Bachelor's Degree in Business,… more
- Providence (OR)
- …will:** + Support timely completion of compliance related audits and investigations of the Special Investigations Unit ( SIU ) at the Health Plan + ... must empower them._** **Providence Health Plan is calling an Investigator , Special Investigation Unit who...multiple cases and audits simultaneously + May assist Senior Investigator or SIU Director in developing, implementing… more
- Commonwealth Care Alliance (Boston, MA)
- … Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) Special Investigation Unit ( SIU ). The position reports directly to the Sr. ... CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review, coding knowledge and… more