- USAA (Louisville, KY)
- …of what truly makes us special and impactful. **The Opportunity** As a dedicated ** Manager , Special Investigations Unit for Property & Casualty** , ... actions and decisions to carry out proactive claim's projects and investigations . + Reviews and evaluates investigation recommendations from investigators to ensure… more
- CVS Health (Frankfort, KY)
- …The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding ... SIU schemes. + Act as management back-up and supports the team when the manager is out of the office. + Maintains up-to-date coding knowledge, including new changes… more
- Molina Healthcare (Louisville, KY)
- …accountability for compliance by overseeing, follow-up and resolution of investigations . **KNOWLEDGE/SKILLS/ABILITIES** + Provides oversight and review of the SIU ... referral intake and investigation process while giving guidance and direction to team on case investigation steps and actions. + Works with leadership to maintain and revise policies and procedures, fraud, waste, and abuse plans, annual audit work plans,… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** Under direct supervision of the Manager , SIU, the Team Lead is responsible to lead a small team of investigators and provide ... daily investigative activities as a back-up to the SIU Manager . This position will be accountable for tracking on.... This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight… more
- Thorntons LLC (Shelbyville, KY)
- The General Manager (GM) is responsible for managing all aspects of the business to ensure that Guests are delighted with a fast, friendly, fresh, clean, and ... is followed relating to safety, accidents, and incidents including reporting, investigations , and documentation *Create a place of welcoming and belonging for… more
- Elevance Health (Louisville, KY)
- …questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern. ... analysis and clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance… more
- CVS Health (Frankfort, KY)
- …are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This is ... datasets. + Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider… more
- ABM Industries (Louisville, KY)
- …AAP/EEO, and special projects. May contribute to the development of unit specific policies or programs. This role is **Onsite (Mon-Fri)** at **4703 Allmond ... a consultant to front-line leaders on human resource-related issues. The successful HR Manager acts as an on-site employee champion and change agent. The role… more