• Senior Special Investigations

    CVS Health (Annapolis, MD)
    …strategic initiatives, along with a team of medical coders/nurses supporting Aetna's Special Investigations Unit. Key Responsibilities: + Leadership: Leads a ... team of coding /nursing professionals who conduct reviews of medical records and...coder/nurse reviews, ensuring compliance with ICD-10, CPT and HCPCS coding guidelines. Assist with department build and implementation of… more
    CVS Health (05/24/25)
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  • Clinical Provider Auditor Senior - Maryland…

    Elevance Health (Hanover, MD)
    …lifecycle. + Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, ... **Clinical Provider Auditor Senior ** **Supports Payment Integrity line of business** _Location:_...trends and changes in laws/regulations. + Collaborates with the Special Investigation Unit and other internal areas on matters… more
    Elevance Health (05/29/25)
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