The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for o

The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for o

Claims Clerk Job Locations US OH Cincinnati Requisition ID 2024 17763 # of Openings 1 Category (Portal Searching) Administrative/Clerical Position Type (Portal Searching) Regular Full Time Overview The Claims Clerk will review insurance claims forms and documents for accuracy and completion and obtain missing information as necessary. Determines claims coverage by examini

HYBRID 2 3x in Mason Office. $2000.00 missing equipment fee is assessed , if equipment is not returned. Duration 06/30/2024 Temp to hire or extension Data Entry Test Scores required on Resumes. If not received, will decline resume. Hours M F/Full Time; 8 4 30 (30 Minute lunch) Hybrid 2x in office a week.. Must have adequate WFH space and follow all Client remote protocol.

Fast paced field environment with frequent face to face, customer interaction Ability to traverse ladders, roofs, crawl spaces, and damaged property Typically inspects multiple losses per day requiring car travel between locations Evaluates and settles property related damages (primarily) between $10,000 and $100,000 (aggregate); occasionally handles losses that exceed $1

The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for o