Investigator II
2 weeks ago
**Investigator II** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. The **INVESTIGATOR II** 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** : + 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.
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Equity, Community, and Title IX Program Director
3 weeks ago
Roanoke, United States InsideHigherEd Full time(posted 3/6/24)Hollins University in Roanoke, Virginia seeks applications for an Equity, Community, and Title IX Program Director.About the RoleThe Equity, Community, and Title IX Program Director develops and/or manages Title IX and bias responses. This position provides leadership and informational programs to help students develop and maintain healthy...
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Patient Access Rep II: Admissions
2 hours ago
Roanoke Rapids, NC, United States Vidant Health Full timeJob Description ECU Health About ECU Health ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers...
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Patient Access Rep II: Admissions
7 hours ago
Roanoke Rapids, NC, United States Vidant Health Full timeJob Description ECU Health About ECU Health ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers...
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Patient Access Rep II: Admissions
28 minutes ago
Roanoke Rapids, NC, United States Vidant Health Full timeJob Description ECU Health About ECU Health ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers...
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PATIENT ACCESS REP II: ADMISSIONS
6 days ago
Roanoke Rapids, NC 27870, USA, United States Vidant Health Full timeJob DescriptionECU HealthAbout ECU HealthECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing...
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PATIENT ACCESS REP II: ADMISSIONS
4 weeks ago
Roanoke Rapids, NC 27870, USA, United States Vidant Health Full timeJob DescriptionECU HealthAbout ECU HealthECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing...
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Patient Access Rep II: Admissions
4 hours ago
Roanoke Rapids, NC, United States Vidant Health Full timeJob Description ECU Health About ECU Health ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers...
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PATIENT ACCESS REP II: ADMISSIONS
4 weeks ago
Roanoke Rapids, NC 27870, USA, United States Vidant Health Full timeJob DescriptionECU HealthAbout ECU HealthECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing...
