- CVS Health (Raleigh, NC)
- …strategic initiatives, along with a team of medical coders/nurses supporting Aetna's Special Investigations Unit . Key Responsibilities: + Leadership: Leads ... CPT and HCPCS coding guidelines. Assist with department build and implementation of SIU coding quality program. + Training: Assesses team's training needs and works… more
- Prime Therapeutics (Raleigh, NC)
- …of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit ( SIU ) teams. **Responsibilities** + Perform ... and/or coordination with an external collection agency + Evaluate audits, investigations and/or claims identified for potential recoupment to verify that results… more
- CVS Health (Raleigh, NC)
- …are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more
- Travelers Insurance Company (Raleigh, NC)
- …internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit . + ... Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as… more
- RELX INC (Raleigh, NC)
- …informed decisions to enhance investigations . About the Team: The Public Safety Special Investigative Unit ( SIU ) is comprised of former law enforcement ... offerings to provide real-time investigative insight for LexisNexis customers. The Public Safety SIU also serves to work with the sales team and customer by… more