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Elevance Health
Elevance Health
Sponzor vizuma H1BB2BZdravstveno varstvoZdravstveno zavarovanje
Elevance Health je podjetje na področju zdravstva in zdravstvenega zavarovanja, ki razvija širši in dolgoročni pristop k podpori zdravju ljudi. Njegovo delo združuje zdravstvene ugodnosti, integrirane storitve za celostno zdravje in digitalne zdravstvene zmogljivosti, zasnovane za učinkovitejše povezovanje zdravstvene oskrbe in zavarovalnega kritja. Z zaposlenimi, ki jih je skoraj 100.000 in skrbijo za več kot 118 milijonov ljudi, Elevance Health ponuja delovna mesta v veliki multidisciplinarni organizaciji, osredotočeni na izboljšanje zdravstvenih izidov, razvoj zdravstvenega sistema in podporo močnejšim skupnostim.
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Delovna mesta v podjetju

Healthcare Fraud Investigator II

Investigate healthcare fraud, review claims, and recover funds for Elevance Health plans and clients. Build cases using claims data and work with law enforcement, legal teams, and internal stakeholders.

USZdružene države AmerikeFLFloridaTXTeksasHibridnoPolni delovni časSrednja ravenSeniorZahtevani Jezik: angleščinaPreiskovalecSplošno

Opis

  • Investigate suspected healthcare fraud and develop cases against perpetrators
  • Recover company and client funds paid on fraudulent claims
  • Review claims for coding accuracy, data mining, entity review, and potential law enforcement referral
  • Analyze facility, professional, and pharmacy claims using proprietary data and systems
  • Develop enterprise-wide investigations that may affect multiple health plans, business lines, or states
  • Build and maintain working relationships with law enforcement
  • Coordinate with senior management and the legal department throughout investigations
  • Help train internal and external groups
  • Help develop policies and procedures to prevent company asset losses

Zahteve

  • Bachelor’s degree and at least three years of related experience, or an equivalent combination of education and experience
  • Advanced Excel skills, including pivot tables and analysis of large datasets
  • Familiarity with CPT coding
  • CFE, AHFI, AAPC fraud certification, or coding certification preferred
  • Knowledge of health plan policies and benefit program management, particularly negotiation, preferred
  • Investigative experience, such as in health insurance or law enforcement, preferred
  • Must live within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law
  • For certain patient- or member-facing roles, new hires must receive COVID-19 and influenza vaccinations unless they provide an acceptable explanation

Ugodnosti

  • Merit pay increases
  • Paid holidays
  • Paid time off
  • Incentive bonus programs
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Short-term disability coverage
  • Long-term disability coverage
  • 401(k) plan with matching contributions
  • Employee stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
  • Full-time virtual work arrangement, with in-person attendance required for training sessions

Sorodna delovna mesta

FVI School of Nursing and Technology

Clinical Coordinator – Nursing Student Placements

FVI School of Nursing and Technology
51 – 200 Zaposleni
B2CIzobraževanjeZdravstveno varstvo
USZdružene države AmerikeFLFloridaHibridnoPolni delovni časSrednja ravenSeniorZahtevani Jezik: angleščinaKlinični koordinatorSplošno

Coordinate clinical placements, schedules, records, and compliance for nursing students in Miramar and Miami. Work with clinical partners, faculty, students, and nursing leadership to support program requirements.

Odpri