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SIU Investigator - CL8301EBMagellan Health Services - Columbia, MDThis position is responsible for preventing and/or recovering inap- propriate health benefit payments due to claims processing and/or abusive and fraudulent practices, as well as lead the complex and confidential claims audits through investigation, developing case strategies, and complying with state and federal regulatory com- pliance and fraud reporting requirements. ESSENTIAL FUNCTIONS: (Tasks critical to completion of daily workload) A. Conduct claims audits and investigations to determine whether and to what extent fraud has occurred; analyze audit data; generate letters to providers and/or members and create and maintain thorough case documentation B. Provide intake, consultation, case strategy recommenda- tions, review processes and referrals to appropriate depart- ments, i.e. See job listing >30+ days ago from Magellan Health Services Inc - Save - Block - Flag - More Tools...
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Magellan Health Services
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Headquarters:
55 Nod Rd
Avon, CT 06001
Phone: 860-507-1900
http://www.magellanhealth.com - Line of Business: Provider Of Psychiatric Services
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Key Numbers:
Company Type Public (MGLN:NMS) Company Revenue $500M+ Company Size 1000 - 5000 employees
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