The Clinical Special Investigator is responsible for identifying and investigating suspected cases of claim and program fraud waste or abuse. Proactive review of claims reports and anti-fraud software reports to identify and initiate investigations Apply clinical standards, medical policies, and coding guidelines when reviewing medical records and claims data Work with the medical director to provide a clinical/coding summary and complete cases based on findings Maintain detailed documentation including interview notes, investigative steps, summaries, and case outcomes Communicate effectively in writing and orally about case findings and coding guidelines Participate in the development and annual review of policies, procedures, and desktops

As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Ensure compliance with legal, regulatory, and organizational standards. Combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Communicate professionally with providers, practice management, and other stakeholders in writing or verbally. Code medical records using ICD-10 and CPT coding rules and guidelines. Enter and validate charges using appropriate tools and validate diagnoses with the medical documentation provided. Compare charges on accounts with the procedures coded and identify any discrepancies. Notify Coding Manager of any discrepancies and collaborate as needed to rectify the account. Identify trends and educational opportunities to ensure proper coding, documentation, and accuracy of billing within areas of responsibility/specialty.

This role involves being a key resource to clients navigating the complex world of employee ownership (ESOPs). You will manage the full cycle of ESOP plan administration and build long-term, trusted relationships. Managing end-to-end client engagements Performing compliance testing, including 409(p), recordkeeping, distributions, and regulatory reporting Identifying and solving technical plan issues Collaborating with internal teams and client contacts to ensure seamless service

The role of Auto Desk Appraiser Level II involves determining the scope and cost of auto repairs for damages caused by collision or other risks. The appraiser reviews shop estimates and/or photos of the damaged vehicle and works to reach a mutually acceptable repair estimate with the repair facility based on client guidelines and industry standards. Review and/or rewrite auto body shop estimates for collision and other material damage losses, making changes based on industry standard procedures. Obtain agreement on scope and cost of repairs with repair facilities. Ensure that repair estimates and supplements are properly documented as required. Provide written reports to clients on adjustments made in the submitted estimates. Prepare and submit total loss condition reports in cases of potential total loss claims.