![Elevance Health](https://media.trabajo.org/img/noimg.jpg)
Investigator II
3 weeks ago
Investigator II
Schedule: 1-2 days per week in the office (Hybrid 1)
Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of an Elevance Health PulsePoint location.
The Investigator II position is responsible for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims.
How you will make an impact:
Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.
Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health plan, line of business and/or state.
Effectively establish rapport and on-going working relationship with law enforcement.
May interface internally with Senior level management and legal department throughout investigative process.
May assist in training of internal and external entities.
Assists in the development of policy and/or procedures to prevent loss of company assets.
Minimum Requirements:
- Requires a BA/BS and minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Medicare investigative experience preferred.
Fraud certification from CFE, AHFI, AAPC or coding certificates preferred.
Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred.
Health insurance, law enforcement experience preferred.
-
Intermediate knowledge of Microsoft Excel.
-
Investigator II
3 weeks ago
West Des Moines, United States Elevance Health Full timeDescription Investigator II Schedule : 1-2 days per week in the office (Hybrid 1) Location: This position will work a hybrid model (remote and office). The candidate must live within 50 miles of our Elevance Health PulsePoint location in West Des Moine, Iowa (in Iowa). The Investigator II position is responsible for the identification, investigation and...
-
Investigator II
2 weeks ago
West Des Moines, United States Elevance Health Full timeDescription Investigator II Schedule : 1-2 days per week in the office (Hybrid 1) Location: This position will work a hybrid model (remote and office). The candidate must live within 50 miles of our Elevance Health PulsePoint location in West Des Moine, Iowa (in Iowa). The Investigator II position is responsible for the identification, investigation and...
-
Internal Security Investigator Ii
1 week ago
Des Plaines, United States State of Illinois Full time**Agency** : Department of Human Services **Opening Date**: 06/07/2024 **Closing Date/Time**:06/21/2024 **Salary**: Anticipated Salary (Effective 7/1/24): $6,688 - $9,745 per month ($80,256 - $116,940 per year) **Job Type**: Salaried **County**: Cook **Number of Vacancies**: 2 **Plan/BU**: RC062 **Posting Identification Number 37045** **Position...
-
Technician II Quality Control Field
1 week ago
West Des Moines, United States UtiliQuest, LLC. Full timeOverview and Essential Functions Looking for an opportunity to make a difference? Then you may have found your next career move. Prince Telecom's commitment to deliver outstanding service that consistently exceeds customer expectations has grown the company to become one of the nation's largest fulfillment providers. With a national footprint and over 850+...
-
Field Service Engineer II
3 weeks ago
Des Moines, United States Omnicell Full timeJob DescriptionField Service EngineerJoin Omnicell, a pioneering force in healthcare technology, as a Field Service Engineer (FSE) I or II, where your work will directly impact patient care and outcomes. Our FSEs provide troubleshooting, repair services, and scheduled preventive maintenance for Omnicell's pharmacy and supply automation solutions at customer...
-
Field Service Engineer II
2 weeks ago
Des Moines, United States Omnicell Full timeJob DescriptionField Service EngineerJoin Omnicell, a pioneering force in healthcare technology, as a Field Service Engineer (FSE) I or II, where your work will directly impact patient care and outcomes. Our FSEs provide troubleshooting, repair services, and scheduled preventive maintenance for Omnicell's pharmacy and supply automation solutions at customer...
-
Deviation Investigator-writer Ii
2 days ago
West Lebanon, United States Novo Nordisk Full time**About the Department** Site New Hampshire, located in West Lebanon, is where Novo Nordisk’s life-saving treatments are brought to life. Our manufacturing facility produces a global supply of our hemophilia and growth hormone product lines, as well as our next generation of cutting-edge medications. What we offer you: - Leading pay and annual...
-
Field Service Engineer II
3 weeks ago
Des Moines, United States Omnicell Full timeJob DescriptionField Service Engineer Join Omnicell, a pioneering force in healthcare technology, as a Field Service Engineer (FSE) I or II, where your work will directly impact patient care and outcomes. Our FSEs provide troubleshooting, repair services, and scheduled preventive maintenance for Omnicell's pharmacy and supply automation solutions at customer...
-
Deviation Investigator-Writer II
4 weeks ago
West Lebanon, United States Novo Nordisk AS Full timeThe Deviation Investigator-Writer is responsible for investigating and writing of deviations to the manufacturing process and other operational problems as assigned. This position is responsible for leading investigations to ensure the written invest Investigator, Writer, Process Engineer, Operations, Technical, Manufacturing, Business Services
-
Engineer II-Municipal Transportation
3 weeks ago
Des Moines, United States HNTB Full timePosition or Keyword (Leave blank to see all) Engineer II-Municipal Transportation St. Louis , Missouri Job Category: Engineering Group Full/Part Time: Full time Job Type: Regular What We're Looking For At HNTB, you can create a career that is meaningful to you while building communities that matter to all of us. For more than a century, we have been...
-
EP Mapping Specialist II
2 weeks ago
Des Moines, Iowa, United States Boston Scientific Full timeAdditional Location(s): US-IA-Central/Des MoinesDiversity - Innovation - Caring - Global Collaboration - Winning Spirit - High PerformanceAt Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With...
-
EP Mapping Specialist II
3 weeks ago
Des Moines, Iowa, United States Boston Scientific Full timeAdditional Location(s): US-IA-Central/Des MoinesDiversity - Innovation - Caring - Global Collaboration - Winning Spirit - High PerformanceAt Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With...
-
Supervisory Criminal Investigator
2 months ago
West Paterson, United States U.S. Department of Justice Full timeSummary This job is open to Career transition (CTAP, ICTAP, RPL) Federal employees who meet the definition of a "surplus" or "displaced" employee. Internal to an agency Current federal employees of this agency. Clarification from the agency Applications will be accepted from internal employees only of the Bureau of Alcohol, Tobacco, Firearms and...
-
EP Mapping Specialist II
3 weeks ago
Des Moines, Iowa, United States Boston Scientific Full timeAdditional Location(s): N/ADiversity - Innovation - Caring - Global Collaboration - Winning Spirit - High PerformanceAt Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest...
-
Engineer II-Municipal Transportation
1 week ago
Des Moines, United States HNTB Full timeWhat We're Looking For At HNTB, you can create a career that is meaningful to you while building communities that matter to all of us. For more than a century, we have been delivering solutions for some of the largest, most complex infrastructure projects across the country. With our historic growth, it is an exciting time to join our team of...
-
Network Security Engineer
3 weeks ago
Des Moines, United States GuidePoint Security Full timeAn active Top Secret/SCI clearance is required prior to consideration for this role. Work is 100% onsite. A Network Security Engineer is part of a team of skilled Cybersecurity professionals that support the design, build, and sustainment of network based cyber defense capabilities within the organization. Network Security Engineers interact daily with a...
-
Analyst - Data Visualization (Remote)
3 weeks ago
Des Moines, United States Workoo Technologies Full timeAbout the job Analyst - Data Visualization (Remote) You'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. Our company strives to hire and retain the best people by engaging, developing and rewarding employees. Essential Functions: Under the direction...
-
Analyst - Data Visualization (Remote)
3 weeks ago
Des Moines, United States Workoo Technologies Full timeAbout the job Analyst - Data Visualization (Remote) You'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. Our company strives to hire and retain the best people by engaging, developing and rewarding employees. Essential Functions: Under the direction...
-
Patient Access Lead
3 weeks ago
Des Moines, United States BJC HealthCare Full timeAdditional Information About the Role Great Opportunity! Do you enjoy being a service to others, have a passion for healthcare, and have excellent customer service skills? If so, Barnes Jewish Hospital is looking to hire a Patient Access Rep LEAD !! Full Time day time hours Roatating weekends and Holidays On Call Daily Pay and a $750 Sign on Bonus Overview...
-
Sonographer-Echocardiography II
4 weeks ago
Des Moines, United States UnityPoint Health Full timeWhy UnityPoint Health? Commitment to our Team – We’ve been named a by Becker’s Healthcare for our commitment to our team members. Culture – At UnityPoint Health, you Come for a fulfilling career and experience guided by uncompromising values and unwavering belief in doing what's right for the people we serve. Benefits – Our competitive ...