- Molina Healthcare (Lexington, KY)
- …the audit process and provide recommendations for system enhancement to augment investigative outcomes and performance. + Accurately tracks, reports, and follows up ... on overpayments and recoveries + Leads business requirement process and reporting to ensure proper and timely notification of case activity to the appropriate regulatory and/or law enforcement agency. **JOB QUALIFICATIONS** **Required Education** Bachelor's… more
- Molina Healthcare (Lexington, KY)
- …on daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on investigations conducted by his/her ... **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide… more
- USAA (Lexington, KY)
- …what truly makes us special and impactful. **The Opportunity** As a dedicated ** Manager , Special Investigations Unit for Property & Casualty** , you will ... be responsible for operational management of Claims fraud investigative teams. Directs field and desk staff in the...investigative tools and techniques to guide and coach special investigators. + Proven ability to build and maintain… more
- CVS Health (Frankfort, KY)
- …Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices ... CMS guidelines related to the audit. + Assist with investigative research related to coding questions, state and federal...as management back-up and supports the team when the manager is out of the office. + Maintains up-to-date… more