• Investigator , Coding SIU

    Molina Healthcare (Augusta, GA)
    **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 + Thorough… more
    Molina Healthcare (02/19/25)
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  • Senior Clinical Investigative Consultant Meritain…

    CVS Health (Austin, TX)
    …self-insured plans for our Meritain TPA business. This role will work within the Special Investigations Unit , while also working with various stakeholder ... well as generate, reports as needed-an analytical and statistical background. **Education:** + CPC Coding Certificate or equivalent + Nursing degree + RN license… more
    CVS Health (02/15/25)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar in the healthcare ... Audit Manager, theAnalyze and interpret patient medical records pertaining to FWA investigations Compare to information submitted on the claims in order to determine… more
    Fallon Health (02/07/25)
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