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Inpatient Facility Medical Coder
American IT Staff
…and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National…
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Provider Enrollment Certification Auditor/Documentation Specialist
CSRA State and Local Solutions LLC
…impactful mission outcomes as a Provider Enrollment Certification Auditor/Documentation Specialist. Here, you’ll see the bigger picture on mission initiatives and where your program…
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Supervisor - Audit/Investigation
Qlarant
…judgments related to audits/investigations of potential Medicare fraud waste and abuse audits/investigations or cases compliance cases (e.g. Medicare and/or Medicaid) that meet established…
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Senior Compliance Oversight Specialist (RN)
Centene
…Compliance & Ethics Professional (CCEP); Certified Internal Auditor (CIA); or Certified Fraud Examiner (CFE)…
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Agency Compliance Manager
Arizona Department of Administration
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need.…
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Lead Compliance Oversight
Centene
…oversight and monitoring and in meeting the requirements of State Medicaid Programs, OIG and CMS…
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Medicaid Auditor (Full-time, Remote)
Integrity Management Services, Inc.
In this role, the Medicaid Auditor will be responsible for performing and reporting on Medicaid Managed Care Plans and providers to identify potential fraud, waste, and abuse; issue…
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Medicaid Auditor/Investigator
Peraton
We are looking to add a Medicaid Auditor/Investigator to our SGS team of talented professionals.
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Medicaid Auditor/Investigator
Peraton
We are looking to add a Medicaid Auditor/Investigator to our SGS team of talented professionals.
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Behavioral Health Auditor
CVS Health
The Behavioral Health Auditor is responsible for reviewing medical, behavioral health, and other healthcare provider records to ensure compliance with coding, documentation, state, federal,…
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Director, Contract Operations & Revenue Integrity
Otsuka America Pharmaceutical, Inc
Oversee validation processes for all commercial, Managed Care, PBM, and Medicare/Medicaid rebate claims.
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Clinical Auditor I
WellSense Health Plan
The Clinical Auditor I performs detailed, retrospective chart audit review, comparing medical documentation with paid charges. The Clinical Auditor I is a liaison and resource between…
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Healthcare Fraud Investigator
Council Capital
…integrity platform pairs analytics with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial, and FEP lines of business, returning significant value to the…
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Medicaid Fraud Auditor
Peraton
We are looking to add a Medicaid Fraud Auditor to our SGS team of talented professionals.
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