- Molina Healthcare (Milwaukee, WI)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... School Diploma / GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years of experience working in… more
- Molina Healthcare (Kenosha, WI)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for… more
- Sanford Health (Marshfield, WI)
- …data analytics, investigation, claim auditing and other areas related to Special Investigations. Completes reports of investigative findings and recommends ... investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred -… more
- Highmark Health (Madison, WI)
- …be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential ... agencies through closure of the case. Conduct audits for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL… more