Clinical Fraud and Abuse Investigation Role
2 days ago
Elevance Health is a health company dedicated to improving lives and communities. Our mission is to provide innovative solutions and exceptional services to our members and the communities we serve. We are committed to creating a culture that values diversity, equity, and inclusion.
Job Summary: We are seeking a skilled Clinical Fraud Investigator II to join our team. The successful candidate will be responsible for identifying potential risks associated with fraud and abuse in the healthcare industry. Key responsibilities include conducting data mining activities, performing comprehensive analysis and clinical evaluation of collected data, and collaborating with internal teams to address matters of mutual concern.
Key Responsibilities:
* Conducts data mining activities using available tools and internal data warehouse.
* Performs comprehensive analysis and clinical evaluation of the collected data.
* Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.
Requirements:
* Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA).
* Minimum of 4 years related experience, including at least 1 year in a Clinical Fraud and Abuse Investigation area.
What We Offer:
A competitive salary, ranging from $70,140 to $120,240 per year, based on location and experience. You will also enjoy a comprehensive benefits package, including merit increases, paid holidays, Paid Time Off, incentive bonus programs, medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
-
Clinical Fraud Investigator Specialist
2 days ago
Grand Prairie, Texas, United States Elevance Health Full timeAbout the Role\Elevance Health is seeking a skilled Clinical Fraud Investigator II to join our team. This position involves identifying potential risks associated with fraud and abuse, conducting data mining activities, and performing comprehensive analysis of collected data.\\Responsibilities:\\Conducts data mining activities using available tools and...
-
Clinical Fraud Investigator
3 weeks ago
Grand Prairie, Texas, United States Elevance Health Full timeJob OverviewElevance Health is a leading health company dedicated to improving lives and communities. We are seeking an experienced Clinical Fraud Investigator to join our team in a critical role.About the RoleThis position involves identifying potential risks associated with fraud and abuse in the healthcare industry. The successful candidate will be...
-
Autism Therapist
3 weeks ago
Grand Prairie, Texas, United States Action Behavior Centers Full timeAbout Our CompanyAction Behavior Centers is a premier provider of Applied Behavior Analysis (ABA) therapy services, dedicated to empowering children with Autism Spectrum Disorder to reach their full potential.Job Title: Board Certified Behavior Analyst (BCBA)Estimated Salary: $60,000 - $90,000 per yearOur team is seeking a highly motivated and experienced...
-
Key Role: Billing Operations Specialist
2 weeks ago
Grand Prairie, Texas, United States Mooring Commercial Construction and Disaster Restoration Full timeJob OverviewWe are seeking a highly skilled and organized Billing Analyst to join our team at Mooring Commercial Construction and Disaster Restoration. As a key member of our operations team, you will be responsible for empowering the mitigation department by working closely with local and CAT Operations teams in daily tasks and ongoing initiatives.
-
Clinical Autism Specialist
2 weeks ago
Grand Prairie, Texas, United States Action Behavior Centers Full timeUnlock Your Potential as a Clinical Autism SpecialistWe are seeking a highly skilled and compassionate Board Certified Behavior Analyst (BCBA) to join our team at Action Behavior Centers. As a Clinical Autism Specialist, you will play a vital role in providing personalized case management and treatment for children with Autism Spectrum Disorder.With an...
-
Clinical Education Specialist
3 weeks ago
Grand Prairie, Texas, United States Medical City Dallas Full timeExplore a rewarding career as a Clinical Education Specialist - Respiratory Therapy at Medical City Dallas, a leading provider of healthcare services in the nation. Our comprehensive total rewards package supports your health, life, career, and retirement, ensuring you have the resources to excel in your role.About UsMedical City Dallas is a 895+ bed...
-
Clinical Training Development Specialist
3 weeks ago
Grand Prairie, Texas, United States Amergis Full timeAmergis seeks a Clinical Training Development Specialist to facilitate performance-based learning. This role is responsible for providing specialized skills training in sales, clinical/healthcare regulations, leadership, and technical areas.Key Responsibilities:Develop educational programsCoordinate and facilitate educational sessionsPrepare and maintain...
-
Autism Spectrum Disorder Clinical Team Lead
3 weeks ago
Grand Prairie, Texas, United States Action Behavior Centers Full timePremier ABA Provider for Children with AutismWe are a responsive employer committed to delivering exceptional care and services to children with autism spectrum disorder. Our team of experienced professionals is dedicated to creating a supportive and inclusive environment that fosters growth and development.Salary: $100,000 - $150,000 per yearAbout the...
-
Security Operations Specialist
2 months ago
Grand Prairie, Texas, United States Target Full timeSecurity Specialist Role at TargetAs a Security Specialist at Target, you will contribute to a secure work environment for all team members, temporary workers, vendors, and visitors. Your responsibilities will include executing routines to identify and investigate theft, as well as helping to advance Asset Protection partnerships through professional...
-
Clinical Director
2 weeks ago
Grand Prairie, Texas, United States Action Behavior Centers Full timeAbout UsAction Behavior Centers is a premier provider of Applied Behavior Analysis (ABA) services for children with Autism Spectrum Disorder. With a strong commitment to clinical excellence, we have built a community of over 3000 professionals dedicated to making a difference in the lives of our clients.Salary and BenefitsWe offer a competitive salary of...
-
Healthcare Service Coordinator
2 weeks ago
Grand Prairie, Texas, United States Elevance Health Full timeAbout Elevance HealthElevance Health is a leading health company dedicated to improving lives and communities. We are a Fortune 25 company with a rich history in the healthcare industry, seeking leaders who are passionate about making an impact on our members and the communities we serve.Job Title: Healthcare Service Coordinator - Clinical Care...
-
Grand Prairie, Texas, United States Justice, Bureau of PrisonsFederal Prison System Full timeAbout UsThe Federal Bureau of Prisons/Federal Prison System is a dynamic and diverse workplace committed to ensuring the fair and impartial administration of justice for all Americans. Our mission is to protect public safety by ensuring federal offenders serve their sentences in facilities that are safe, humane, and provide reentry programming.Job OverviewWe...
-
Electrical Design Engineer
3 weeks ago
Grand Prairie, Texas, United States DanSources Full timeOverviewDanSources is seeking an Electrical Design Engineer to join our team for a missile development program.Job DescriptionThis role will involve technical support to Supplier Management Teams, developing electrical requirements and designs, interface control documents, and drawings for various hardware components. The successful candidate will conduct...
-
Electrical Engineering Specialist
3 weeks ago
Grand Prairie, Texas, United States Dansources Technical Services Full timeDansources Technical Services is seeking an experienced Electrical Engineer to support a missile development program in Grand Prairie, TX.This role will be responsible for providing technical support to Supplier Management Teams and developing electrical requirements, designs, and interface control documents for various missile safety-critical hardware...
-
Inventory Accuracy Specialist
3 weeks ago
Grand Prairie, Texas, United States Bass Pro Shops Full timeAs an Inventory Accuracy Specialist at Bass Pro Shops, you will play a crucial role in maintaining the accuracy of our retail store inventory. This position requires attention to detail, excellent organizational skills, and the ability to work effectively with various teams.Job SummaryWe are seeking a highly motivated and organized individual to join our...
-
Clinical Care Coordinator
3 weeks ago
Grand Prairie, Texas, United States LHC Group Full timeWe are seeking a skilled and compassionate Registered Nurse to join our home health team in the Grand Prairie area. As a Clinical Care Coordinator, you will be responsible for providing high-quality patient care and coordinating with other healthcare professionals to ensure continuity of care.About the RoleThe ideal candidate will have current RN licensure...
-
LTSS Clinical Care Manager
3 days ago
Grand Prairie, Texas, United States Elevance Health Full timeService Coordinator RoleWe are seeking a highly skilled RN Clinician to join our team as a Service Coordinator, focused on delivering exceptional care to our members. In this role, you will play a vital part in managing member cases and developing tailored care plans.Responsibilities:Conduct thorough assessments to identify member needs and develop effective...
-
Senior Engineer for Missile Development
3 days ago
Grand Prairie, Texas, United States DanSources Full timeSenior Engineer for Missile DevelopmentDanSources is seeking a Senior Engineer for Missile Development to join our team.The successful candidate will be responsible for providing technical support to Supplier Management Teams, developing electrical requirements and designs, and conducting research and problem resolution.Key responsibilities...
-
Truck Driver
3 weeks ago
Grand Prairie, Texas, United States Penske Truck Leasing Co., L.P. Full timeAbout the Job">We are seeking a highly skilled and experienced CDL Class A Truck Driver to join our team at Penske Logistics. As a key member of our operations, you will be responsible for delivering products safely and on time to our customers. ">Salary and Benefits">The estimated salary for this position is $80,000 annually. Additionally, we offer a...
-
Senior Safety Manager
7 hours ago
Grand Prairie, Texas, United States Martin Transportation Systems Full timeJob Title: Senior Safety Manager - Grand Prairie TerminalLocation: Grand Prairie, TXOverview:Martin Transportation Systems is seeking a highly skilled and experienced Senior Safety Manager to lead our safety management team at the Grand Prairie terminal. This key role will ensure compliance with DOT and OSHA regulations, conduct on-site orientations, safety...