- CVS Health (Woonsocket, RI)
- …And we do it all with heart, each and every day. **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure ... and potential to testify **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical… more
- CVS Health (Woonsocket, RI)
- …to travel approximately 10% of time for business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + Knowledge of ... are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded plan… more
- CVS Health (Woonsocket, RI)
- …to provide testimony if needed. + Experience with Excel. **Preferred Qualifications** + Certified Professional Coder + Knowledge of CVS/Aetna's policies and ... be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit (SIU) is looking for an analytically driven individual who is… more
- Point32Health (Canton, MA)
- …Qualifications - what you need to perform the job Certification and Licensure + Certified Professional Coder ("CPC"); Certified Fraud Examiner ("CFE") ... Summary** The Investigator I is an essential team member of the Special Investigation Unit ("SIU") responsible for leading complex provider investigations related to… more
- Highmark Health (Boston, MA)
- …Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability ... SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code… more