Quality Reviewer (Aetna SIU)
CVS Health•Madison, WI
402d•$43,888 - $102,082
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About The Position
The Quality Reviewer at CVS Health is responsible for assessing the thoroughness and accuracy of investigations aimed at preventing fraudulent claims in healthcare. This role involves analyzing cases for clinical and legal review, documenting case activities, collaborating with law enforcement, and providing insights to recover funds lost due to fraud. The position requires a high level of expertise and the ability to present findings to stakeholders, ensuring compliance and supporting the prosecution of fraud cases.
