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Healthcare Fraud Shield
Healthcare Fraud Shield
51 – 200 Xodimlar
KonsaltingSog‘liqni saqlashTibbiy sug‘urta
Healthcare Fraud Shield develops payment integrity and cost containment solutions for healthcare insurers. Its AI-driven platform combines anomaly detection with a proprietary data fusion library to identify potential fraud, waste, abuse, and errors in claims. The end-to-end service supports audits before and after payment, bringing claims data together with expert guidance and actionable findings to help insurers improve review accuracy and control costs.
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Kompaniyadagi ish o‘rinlari

Remote Coding Auditor – Missouri

Review medical records and claim codes for Healthcare Fraud Shield’s fraud investigations. Support accurate billing, reimbursement, and regulatory compliance.

USAmerika Qo‘shma ShtatlariMOMissuriMasofaviyTo‘liq stavkaJuniorTalab Qilinadigan Til: inglizchaAuditor

Tavsif

  • Review health records against billed ICD-10-CM, CPT, HCPCS, and Revenue codes.
  • Compare claimed procedures and codes with medical records.
  • Assess claim information to identify the amount and nature of billable services.
  • Evaluate whether billing and reimbursement are appropriate.
  • Record findings for each claim line in a spreadsheet.
  • Prepare written summaries of review findings.
  • Extract CPT, HCPCS, Revenue, DRG, and ICD-10 codes from medical records.
  • Keep current with coding guidelines and relevant federal and state regulations.
  • Follow company privacy and security standards.
  • Safeguard confidential health information in accordance with applicable law.
  • Review an average of at least 5–10 claim lines per hour.
  • Carry out other duties as needed.

Talablar

  • Hold a Certified Professional Coder credential.
  • Have at least one year of investigative experience.
  • Hold one of the following credentials: CPC, CCS, or CCA.
  • Know medical terminology.
  • Know coding practices for CPT, HCPCS, Revenue, DRG, and ICD-10 codes.
  • Understand specialty medical practices.
  • Pay close attention to detail.
  • Communicate effectively in writing and verbally.
  • Have strong listening skills.
  • Meet defined performance and productivity targets.
  • Have strong computer skills.
  • Handle confidential and sensitive information discreetly and securely.
  • Have high-speed internet with at least 25 Mbps download and 5 Mbps upload; satellite internet is not accepted.

Imtiyozlar

  • Medical, dental, and vision insurance.
  • 401(k) retirement plan with employer match.
  • Paid vacation and sick leave.
  • Seven paid holidays and two floating holidays.
  • Paid maternity and paternity leave.
  • Disability and life insurance.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program (EAP).
  • Professional and career development programs.
  • Eligible to work remotely.

O‘xshash ish o‘rinlari

Terumo Medical Corporation

Territory Manager, Interventional Systems — Philadelphia

Terumo Medical Corporation
1 001 – 5 000 Xodimlar
H1B vizasi homiysiIshlab chiqarishKonsaltingSog‘liqni saqlash
USAmerika Qo‘shma ShtatlariPAPensilvaniya
50 000 $ – 65 000 $ / yil
OfisdaTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaMijozlar bilan ishlash menejeriSotuv

Lead sales of Terumo Interventional Systems devices to hospitals and outpatient facilities in the Philadelphia area. Build accounts, support procedures, educate clinicians, and meet territory sales goals.

Ochish
Aleph Alpha

Senior AI Researcher, Foundation Model Pre-Training — Aleph Alpha, Heidelberg

Aleph Alpha
51 – 200 Xodimlar
B2BSun’iy intellekt
DEGermaniyaGibridTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaMashinaviy o‘qitish muhandisiSunʼiy intellekt tadqiqot olimi
PythonPyTorchTaqsimlangan tizimlar

Lead architecture and large-scale pre-training work for Aleph Alpha’s European foundation models, shaping training methods across thousands of GPUs. Build and refine PyTorch training recipes with the Heidelberg-based hybrid team.

Ochish