Investigate instances of potential healthcare fraud, waste, and/or abuse (FWA) Conduct telephonic and/or in person interviews of members, providers, and other related parties to gather information in support of investigations Review and analyze claims data to identify patterns and indications of potential FWA Conduct onsite provider investigations for claim and/or clinica

Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Identify appropriate assignment of CPT and ICD 10 Codes for outpatient sur

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Careers with MedExpress. At MedExpress, we believe in delivering quality, convenient, affordable health care and exceeding our patients' expectations. Our neighborhood medical centers are open every day from 8 8 with a full medical team and no appointments necessary to help patients get in, get healthy, and get back to what's really important . We provide a broad scope of

Perform remote and onsite hospital bill charge audits as assigned while meeting department quality expectations Manage case inventory to ensure timely scheduling of remote and onsite audits while maintaining weekly productivity goals Ability to assess case details and provide input into audit potential of facilities & cases Effectively interact and communicate with teamma

Provide exceptional customer service to all consumers and members of the clinic staff Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist Orders, receives and stores incoming pharmacy supplies Receives and processes wholesaler medication orders Verifies medication stock and enters data in computer to ma

Draws blood specimens from the patients of the clinic for laboratory analysis Ensures sample is drawn from the proper tube, labeled correctly, and patient is appropriately identified Verifies patient information and laboratory orders and ensures patient signs appropriate contracts for Clozapine Monitoring Program Files lab results and other medical information into medica

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, c

Identify appropriate assignment of CPT and ICD 10 Codes for outpatient surgery, observation, CVIR, emergency, and ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity accounts Understand the Medicare Ambulatory Payment

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity o

Combine two of the fastest growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and r

$3,000 Sign on BONUS!

$3,000 Sign on BONUS!