Behavioral Fraud Analyst

DESCRIPTION:

We are seeking an individual with strong data analytics experience, preferably in healthcare, to be part of a national investigations team to assist in detecting and investigating potential fraud, waste and abuse.

Responsibilities for the chosen incumbent will include:

  • Work closely with SIU staff and Company clinicians in developing targeted queries to detect potential FWA across broad spectrum of behavioral health data sets
  • Develops desk top tools for investigative staff
  • Periodic project management involved

There is a strong understanding of Current Procedural Terminology (CPT), International Classification of Disease-Ninth Edition (ICD-9) and Healthcare Common Procedural Coding System (HCPCS) that is needed to be successful in this role.

REQUIREMENTS:

Requirements:

  • Minimum of five years experience in developing analytical tools and models, programming database queries, conducting data analysis, and creating reports
  • Intermediate to advanced level in the use of Structured Query Language (SQL) with proven ability to develop complex queries and reports
  • Proficiency with Microsoft Access and Visual Basic for Applications (VBA) at the intermediate to advanced level
  • Ability to thrive in a fast-paced environment
  • Excellent communication skills
  • Ability to work remotely

Additional Assets Preferred:

  • Understanding of statistics to include sampling and extrapolation methodologies and use in investigations and leveraging for negotiations and resolution
  • Certified Professional Coder (CPC or CPC-A)
  • Behavioral health experience
  • Accredited Healthcare Fraud Investigator (AHFI)
  • Minimum of three years experience with healthcare specific fraud detection
  • Master level with SAS programming to conduct data mining, perform queries, and develop tables, forms, reports and graphs; Elements include, but not limited to Macro, SQL, STAT, Enterprise Guide, Online Analytical Processing, (OLAP) Cube, and Enterprise MinerPreferred experience working within a designated health care fraud group, or with a peer review group that identifies and outliers, aberrancies and suspicious utilization patterns outlier behavior intervention and associated investigative practices
  • Knowledge of the health care and benefit industry, as well as specific knowledge around standard behavioral health coding and billing practices

Company Information: United Health Group
Contact Information: Apply Online

URL: HomeJobStop

Web Search Evaluator

DESCRIPTION:

Be part of a global team to evaluate and improve search engine results for one of the world’s top internet search engine companies!

WHO ARE WE

Appen Butler Hill (www.butlerhill.com) is a linguistics services technology company that is focused on helping our clients reach new international markets by leveraging our expertise in over 50 languages and dialects. Our client is one of the world’s top internet search engine companies and is currently seeking internet-savvy freelance Web Search Evaluators.

THE JOB

Web Search Evaluators will review and evaluate internet search results based on specific search terms and provide a rating depending on the relevance of the search result to the search term. The evaluation work is done using an online automated tool.

For most projects, you will be allowed the flexibility to choose the hours you wish to work each day, however you must work 20-22 hours per week, 4 hours per day Monday to Friday (no weekend work at this time). The freelance work is expected to extend through August 17th, 2012, possibly beyond.

REQUIREMENTS:

  • Personal PC that runs Windows Vista or Windows 7 operating system and anti-virus software. Windows XP and Apple platforms, including virtual environments are not acceptable.
  • Minimum screen resolution capabilities of 1280 X 768; desired resolution is 1280 X 1024
  • A high-speed internet connection
  • Ability to problem-solve technical/software issues independently
  • Detail-oriented and organized with strong time management skills and the ability to manage a 20-22 hours per week self- directed work schedule
  • Native English speaker, living in the US
  • Familiar with current cultural, political, business and media affairs in the US
  • Extensive familiarity with a wide variety of online news sources published in the US
  • Avid internet enthusiast with excellent web research and analytical capabilities
  • Completed at least 1-2 years of a university program
  • 1-2 years professional work experience

WHAT WE OFFER

A competitive hourly pay rate, flexible work schedule while working online remotely.

Company Information: Butler Hill
Contact Information: Apply Online

URL: HomeJobStop

Freelance Writer

DESCRIPTION:

California Psychics is in search of freelance writers/bloggers to contribute to our psychic newsletter and blog. We are looking for new contributors to offer fresh content on a variety of topics such as love, relationships, spirituality, and career, all with a new age twist. So if you are a great writer and enjoy all things metaphysical – this is a great opportunity!

Check out our website: www.californiapsychics.com

REQUIREMENTS:

  • Must be well-versed in SEO.
  • Have extensive Web writing experience
  • Understand takeaway value, scanability, and what makes a click-worthy headline
  • Have an area of expertise in love, relationships, sex, astrology, horoscopes, and be familiar with psychic terms and concepts.
  • Must write for our brand, a very well trusted service with dedicated customers
  • Ideas which are fresh, exciting, personal, and compelling for our audience, and to attract new customers
  • Optimally, we’d like writers with proven stats such as CTR, PVS, and other metrics
  • Experience writing quizzes, polls, and other user-friendly content

Company Information: California Psychics
Contact Information: Apply Online

URL: HomeJobStop