Surveillance Investigator - Part Time Allied UniversalSurveillance Investigator - Part TimeSt. Louis, Missouri$20–$25 / hour
Principal Compliance Investigator Centene Corporation GroupPrincipal Compliance InvestigatorMO$107,700–$199,300 / yearThoroughly documents, organizes, and reviews case files, electronic and hardcopy, relative to each investigation in accordance with Company policy and ensures remediation activities are tracked and implemented. This includes defining investigation strategy, preserving evidence, conducting interviews, analyzing records, conducting root cause analysis, and recommended corrective and disciplinary actions.
Principal Investigator, MD Civia HealthPrincipal Investigator, MDCreve Coeur, MOFull timeOur purpose is bold: to bring clinical trials front and center in your community, make them accessible to everyday people, and empower underrepresented communities to participate. At Civia Health, we’re reimagining how clinical trials are delivered—by putting patients first and empowering providers to lead innovation.
Clinical Investigator I (Special Investigation Unit) Centene Corporation GroupClinical Investigator I (Special Investigation Unit)MORemote$56,200–$101,000 / yearLicenses/Certifications: Coding certification from an accredited organization (American Academy of Professional Coders or American Health Information Management Association), RN, LPC, LPN, LCSW, LMHC, PT, OT, or ST or related license. Ideal background includes reviewing medical records for fraud investigations, as well as experience from a specialist physician's office focused on record review and documentation quality.
Clinical Investigator - Behavioral Health Centene Corporation GroupClinical Investigator - Behavioral HealthMORemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Clinical Investigator Behavioral Health Centene Corporation GroupClinical Investigator Behavioral HealthRemote-MO, MORemote$56,200–$101,000 / yearPosition requires the associate to verify authorization for services and written documentation of services provided against claim information, ensure the appropriateness and accuracy of diagnosis and procedure codes supporting such claims, coordinate medical necessity and appropriate level of care determinations with Medical Directors, and validate services against CMS and State-specific coverage, limitations and exclusion guidelines. 2+ years clinical experience with independent license required; 2 years of fraud, waste, and abuse experience required; experience in provider education and managed care organization preferred; coding certification preferred.
Security Investigator-STLCITY BJC HealthCareSecurity Investigator-STLCITYSaint Louis, MOBarnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. The department provides field officers, Bike and mobile patrol, investigators, and a communication unit for monitoring alarm systems and dispatching officers to service and emergency calls.
ER Investigator U.S. BancorpER InvestigatorSaint Louis, MO$105,400–$124,000 / yearIn addition, certain positions may also be subject to the requirements of FINRA, NMLS registration, Reg Z, Reg G, OFAC, the NFA, the FCPA, the Bank Secrecy Act, the SAFE Act, and/or federal guidelines applicable to an agreement, such as those related to ethics, safety, or operational procedures. As a trusted partner, you will be expected to ensure that appropriate stakeholders are brought to the table to discuss the resolution and outcomes for current cases while proactively addressing conditions or problems that could cause situations to reoccur in the future.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)MO$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.