- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Manager , Fraud and Waste Investigator: Nurse Audit/Review performs clinical ... of objectives and determines approach, resources, schedules and goals. The Manager , Fraud and Waste Investigator: Nurse Audit/Review validates and interprets… more
- Molina Healthcare (Bowling Green, KY)
- …and actions. + Works with leadership to maintain and revise policies and procedures, fraud , waste , and abuse plans, annual audit work plans, including department ... accountability for compliance by overseeing, follow-up and resolution of investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU… more
- Elevance Health (Nashville, TN)
- …of 4 years medical coding/auditing experience, including minimum of 1 year in fraud , waste abuse experience; or any combination of education and experience, ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and… more