Clinical Fraud Investigator Role for Healthcare Professionals
6 days ago
At Elevance Health, we are seeking a skilled Clinical Fraud Investigator to join our team. This role is ideal for healthcare professionals with experience in fraud and abuse investigations.
About the JobThe Clinical Fraud Investigator will be responsible for identifying potential risks associated with fraud and abuse in the healthcare industry. This involves conducting data mining activities, performing comprehensive analysis and clinical evaluation of collected data, and examining claims for compliance with relevant billing and processing guidelines.
Key Responsibilities- Conduct data mining activities using available tools and internal data warehouse.
- Perform comprehensive analysis and clinical evaluation of collected data.
- Examine claims for compliance with relevant billing and processing guidelines.
- Identify opportunities for fraud and abuse prevention and control.
To be successful in this role, you will require:
- An Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA).
- A minimum of 4 years related experience, including at least 1 year in a Clinical Fraud and Abuse Investigation area.
We offer a competitive salary range of $70,140 to $120,240 based on location and experience. In addition to your salary, we provide a comprehensive benefits package, including medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
Work EnvironmentWe operate in a hybrid workforce strategy, requiring associates to work at an Elevance Health location at least once per week. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
-
Travel Healthcare Professional
1 day ago
Mason, Ohio, United States Host Healthcare Full timeRole OverviewWe are seeking a highly skilled Speech Therapist to join our team in Mason, OH.About the CompanyHost Healthcare is an award-winning travel healthcare company dedicated to providing exceptional service and support to our clinicians. Our mission is to help you navigate each step of the process, from travel arrangements to housing and...
-
Mason, Ohio, United States Planet Healthcare Full timePlanet Healthcare is currently seeking a skilled traveling medical professional to fill a role in their progressive care unit (PCU) at a facility in Mason City, Iowa.About the OpportunityThis 12-week contract position offers 36 hours of work per week, with shifts lasting 12 hours each. The successful candidate will be required to work night shifts.The...
-
Mason, Ohio, United States Planet Healthcare Full timeAbout the RolePlanet Healthcare is a global leader in clinical staffing, providing exceptional healthcare talent to meet the demands of the industry. We are currently seeking a skilled and experienced Travel Nurse RN Neurology to join our team.Job HighlightsLocation: Mason City, IowaDuration: 14 weeksHours: 40 hours per weekShift: 8 hours, daysEmployment...
-
Travel Healthcare Professional
6 days ago
Mason, Ohio, United States Host Healthcare Full timeAbout the RoleHost Healthcare is seeking a skilled Travel Nurse RN Home Health to join their team for a travel nursing assignment in Ohio.This role offers an excellent opportunity for experienced nurses to work with a reputable healthcare company, providing high-quality patient care while enjoying the benefits of travel nursing.Key ResponsibilitiesDeliver...
-
Healthcare Support Professional
7 days ago
Mason, Ohio, United States Mason City Clinic Full timeJob OpportunityWe are seeking a dedicated Patient Care Assistant to join our team at Mason City Clinic.Estimated Salary: $45,000 - $60,000 per year, depending on experience.About the JobThis is a dynamic role that requires strong communication and organizational skills. As a Patient Care Assistant, you will be responsible for providing exceptional patient...
-
Healthcare Support Professional
2 weeks ago
Mason, Ohio, United States Nursefinders Full timeAbout the RoleA Healthcare Support Professional, working under the guidance of medical staff, provides essential care to patients with various injuries, illnesses, or disabilities. Responsibilities include assisting patients with personal care, ensuring proper hygiene, and helping with medication administration. This role may be found in various settings,...
-
Travel Healthcare Professional
7 days ago
Mason, Ohio, United States Voca Full timeVoca is seeking a skilled Travel Healthcare Professional to join their team in Mason City, Iowa. As a Voca Traveler, you will gain new clinical skills, visit amazing places, and meet awesome healthcare professionals.With our long-standing partnerships with respected healthcare organizations, we identify career opportunities to increase your knowledge and...
-
Travel Healthcare Professional CVOR
7 days ago
Mason, Ohio, United States Host Healthcare Full timeJob OverviewWe are seeking a highly skilled Travel Healthcare Professional with expertise in CVOR to join our team at Host Healthcare. This exciting opportunity allows you to work with a leading healthcare provider and gain valuable experience in a fast-paced environment.About the RoleThis 13-week assignment will see you working as a Registered Nurse - CVOR,...
-
Traveling Healthcare Professional
4 days ago
Mason, Ohio, United States Aequor Healthcare Full timeExciting Opportunity for a Traveling Healthcare ProfessionalAequor Healthcare is seeking a highly skilled and experienced Registered Nurse (RN) to join our team in Mason City, Iowa.Job Highlights:13-week contract with 36 hours per week12-hour shiftsTravel nursing positionAbout the Role:The ideal candidate will have at least two proven years of experience in...
-
Healthcare Professional
4 days ago
Mason, Ohio, United States Planet Healthcare Full timePlanet Healthcare is a global leader in clinical staffing, taking a candidate-first approach to create the right opportunity at the right time for healthcare professionals. We pride ourselves on a consultative method and help to deliver vital healthcare talent today.About Planet HealthcareWe are your advocate and partner during your job search, offering...
-
Traveling Healthcare Professional Wanted
3 days ago
Mason, Ohio, United States RCM HealthCare Travel Full timeJob Opportunity: Travel Nurse RNWe are seeking a skilled and dedicated travel nurse RN for a 13-week assignment in Mason, Ohio.About the JobSpecialty: Home HealthDiscipline: Registered Nurse (RN)The successful candidate will be responsible for providing high-quality patient care in a home health setting.Key Requirements2 years of recent experience in Home...
-
Mason, Ohio, United States IDR Healthcare Full timeAbout the RoleIDR Healthcare is seeking a skilled healthcare professional to join their team as a travel nurse RN Endoscopy. This exciting opportunity allows individuals to explore new locations and experiences while making a positive impact in the field of endoscopy.
-
Travel Healthcare Professional
3 days ago
Mason, Ohio, United States Host Healthcare Full timeCompany OverviewHost Healthcare is an award-winning travel healthcare company dedicated to providing a worry-free experience for Registered Nurses. We offer immediate openings for skilled professionals like you, ensuring a smooth transition into your new role.
-
Mason, Ohio, United States Host Healthcare Full timeJob Title:Speech Therapist - Home HealthAbout the Position:We are seeking a qualified Speech Language Pathologist to join our team for a travel assignment in Mason, Ohio.Key Responsibilities:Provide speech therapy services to patients in their homesDevelop and implement individualized treatment plans to meet patient needsCollaborate with interdisciplinary...
-
Traveling Healthcare Professional
2 days ago
Mason, Ohio, United States IDR Healthcare Full timeIDR Healthcare, a leading healthcare staffing firm, is seeking a highly skilled Traveling Healthcare Professional to join their team in Mason City, Iowa. This exciting opportunity will see you working as a CVOR RN for 13 weeks, covering 40 hours per week on an 8-hour day shift.About IDR HealthcareIDR Healthcare is proud to be employee-owned, and our...
-
Mason, Ohio, United States Planet Healthcare Full timePlanet Healthcare, a global leader in clinical staffing, is seeking a skilled RN for a travel nursing position in Mason City, Iowa.About the JobThis 13-week assignment requires a commitment of 36 hours per week with 12-hour shifts, days. The ideal candidate will have expertise in Endoscopy and be able to adapt to a dynamic work environment.Benefits...
-
Travel Healthcare Professional
2 days ago
Mason, Ohio, United States Planet Healthcare Full timeJob SummaryMason City, Iowa is seeking a skilled Endoscopy Registered Nurse to join our healthcare team. This 12-week travel nursing assignment offers a unique opportunity to work with a variety of patients and develop your clinical skills in a dynamic environment.About the RoleThis position requires a highly motivated and compassionate Endoscopy RN to work...
-
Traveling Healthcare Professional Wanted
6 days ago
Mason, Ohio, United States Host Healthcare Full timeAbout This Job OpportunityWe are seeking a highly skilled Home Health Registered Nurse (RN) to join our team of healthcare professionals on a travel assignment basis. This exciting opportunity will allow you to experience new places, develop your skills, and work in a dynamic environment.Key Responsibilities:Provide high-quality patient care as a Home Health...
-
Mason, Ohio, United States Healthcare Support Full timeSeeking a skilled and experienced Speech Language Pathologist to join our team in Mason, Ohio. As a valued member of our healthcare team, you will provide exceptional patient care and support while traveling across the country.About the Role:We are currently seeking a Speech Language Pathologist to work on a 13-week contract basis, providing high-quality...
-
Travel Healthcare Professional Opportunity
2 days ago
Mason, Ohio, United States Host Healthcare Full timeOverviewHost Healthcare is an award-winning travel healthcare company with a current opening for Registered Nurse - Home Health in Mason, OH.Estimated Salary$_______ (Based on national averages and location)About the RoleThis position involves providing high-quality patient care in a home health setting. As a Registered Nurse, you will work closely with...