Job Details:-

Hiring Organization:- Aetna

Post Name: Senior Investigator

Qualifications:- Bachelor Degree

Industry:- Private

Employment Type:- Full Time

Work Hours:- 8 Hours

Salary:- $26/Hour

Locations:- Jacksonville, USA

Required Qualifications:

Carry your heart to CVS Wellbeing All of us at CVS Wellbeing shares a solitary, clear reason: Carrying our heart to each snapshot of your wellbeing. This reason directs our obligation to convey improved human-driven medical services for a quickly influencing world. Secured in our image — with heart at its middle — our motivation sends an individual message that how we convey our administrations is similarly essentially as significant as what we convey. Aetna Remote Jobs Jacksonville.

Our Heart At Work Behaviors™ support this reason. We need each and every individual who works at CVS Wellbeing to feel engaged by the job they play in changing our way of life and speeding up our capacity to develop and convey answers for make medical services more private, advantageous and reasonable. Aetna Remote Jobs Jacksonville.

Position Synopsis
Conducts examinations to really seek after the anticipation, examination and indictment of medical services misrepresentation and misuse, to recuperate lost reserves, and to follow state guidelines commanding extortion plans and practices. Aetna Remote Jobs Jacksonville.
Conducts examinations of known or associated acts with medical care misrepresentation and misuse. Aetna Remote Jobs Jacksonville.

Speaks with government, state, and neighborhood policing as proper in issues relating to the arraignment of explicit medical services misrepresentation cases. Aetna Remote Jobs Jacksonville.

Examines to forestall installment of false cases committed by guaranteed’s, suppliers, inquirers, client individuals, and so on. Aetna Remote Jobs Jacksonville.
Works with the recuperation of organization and client cash lost because of misrepresentation matters. Aetna Remote Jobs Jacksonville.

Gives input in regards to controls to checking misrepresentation related issues inside the specialty units. Aetna Remote Jobs Jacksonville.

Conveys instructive projects intended to advance prevention and identification of extortion and limit misfortunes to the organization. Aetna Remote Jobs Jacksonville.

Keeps up with open correspondence with constituents inside and outer to the organization.
Involves accessible assets and innovation in creating proof, supporting charges of misrepresentation and misuse. Aetna Remote Jobs Jacksonville.

Investigates and plans cases for clinical and lawful survey.

Archives generally suitable case action in global positioning framework
Makes references and deconflictions, both inward and outside, in the required time span
Cost successfully oversees utilization of outside assets and merchants to perform exercises fundamental for examinations. Aetna Remote Jobs Jacksonville.

Displays ways of behaving illustrated in Worker Capabilities
Required Capabilities
Least three years in medical care field working in misrepresentation, waste and misuse examinations and reviews using logical and research abilities. Aetna Remote Jobs Jacksonville.

Capable in exploring data and recognizing data assets. Aetna Remote Jobs Jacksonville.
Solid verbal and composed relational abilities.

Solid client care abilities. Aetna Remote Jobs Jacksonville.

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Capacity to interface with various gatherings at various levels and give help on an ideal premise. Aetna Remote Jobs Jacksonville.

Capability in Word, Succeed, MS Viewpoint items, Data set search devices, and use in the Intranet/Web to explore data. Aetna Remote Jobs Jacksonville.
Capacity to use organization frameworks to get significant electronic documentation
Capacity to travel and take part in judicial actions, mediations, affidavits, and so forth.

Favored Capabilities
Situated in the Michigan region. In the event that not situated in Michigan, should head out to Michigan. Aetna Remote Jobs Jacksonville.

Qualifications like a certificate from the Relationship of Ensured Misrepresentation Inspectors (CFE), a license from the Public Medical services Hostile to Extortion Affiliation (AHFI)
Charging and Coding affirmations like CPC (AAPC) or potentially CCS (AHIMA)- Information on CPT/HCPCS/ICD10 coding-Involvement in Medicaid/Federal medical insurance
Information on Aetna’s Medicaid strategies and techniques is an or more. Aetna Remote Jobs Jacksonville.

Aetna Remote Jobs Jacksonville $26/Hour ID-10112