- MTA (Brooklyn, NY)
- Claims Fraud Investigator (Special Investigations) Job ID: 7127 Business Unit: MABSTOA Location: Brooklyn, NY, United States Regular/Temporary: Regular ... with enforcement agencies, insurance carriers and organizations dedicated to combating claims fraud. Education and Experience Claim Fraud Investigator +… more
- The Hartford (NJ)
- SIU Investigator - CF08BE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here ... our team as we help shape the future. We are seeking a talented Special Investigator to join our Special Investigations Unit (SIU). This position will be based out… more
- State of Massachusetts (Boston, MA)
- …the Senior Investigator will also recommend improvements to internal and financial controls and will assist in the writing of public advisories and letters ... basis of integrity and demonstrated ability in accounting, auditing, financial analysis, law, management analysis, public administration, investigation or criminal… more
- USAA (Atlantic City, NJ)
- …that really matters. At USAA, we have an important mission: facilitating the financial security of millions of US military members and their families. Not all ... us so special! **The Opportunity** As a dedicated SIU investigator , you will protect USAA and our members from...will protect USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity… more
- SGI Global, LLC (Raleigh, NC)
- SGI Global is seeking a Civil Investigator (Healthcare Fraud and Opioid Matters) to support Affirmative Civil Enforcement ("ACE") Program for the United States ... Attorney's Office for the Eastern District of North Carolina. The investigator will be assigned cases and matters that vary in scope and complexity, but… more
- City of New York (New York, NY)
- …for clarification from the employee and/or seek documented evidence supporting their claims . The EEO Investigator Specialist would also collect documentation ... Agency's Equal Employment Opportunity & Diversity Office seeks to hire an EEO Investigator Specialist who will report directly to the Assistant Commissioner of EEO&D… more
- Woodforest National Bank (The Woodlands, TX)
- …relationships and discovering opportunities to better serve our communities and understand the financial needs of every customer we serve. At Woodforest we care and ... of one of the largest employee-owned banks in the country! The Fraud Investigator I is responsible for reviewing and compiling evidence to substantiate allegations… more
- MyFlorida (Margate, FL)
- LAW ENFORCEMENT INVESTIGATOR II - 79000852 Date: May 3, 2024 Location: MARGATE, FL, US, 33063 The State Personnel System is an E-Verify employer. For more ... No: 828732 Agency: Business and Professional Regulations Working Title: LAW ENFORCEMENT INVESTIGATOR II - 79000852 Pay Plan: Career Service Position Number: 79000852… more
- Bank of America (Washington, DC)
- Senior Internal Investigator ll Jacksonville, Florida;Washington, District of Columbia; Hialeah, Florida; Boston, Massachusetts; New York, New York **Job ... are guided by a common purpose to help make financial lives better through the power of every connection....as front running, market manipulation, and insider trading), whistleblower claims and senior officer misconduct claims . Manages… more
- MyFlorida (Tallahassee, FL)
- …equal employment opportunity, regulatory work as a paraprofessional or higher, claims adjusting, auditing, financial examining, land appraisal work, human ... OPS MEDICAL MALPRACTICE INVESTIGATOR - 64801367 Date: May 9, 2024 Location:...Agency: Department of Health Working Title: OPS MEDICAL MALPRACTICE INVESTIGATOR - 64801367 Pay Plan: Temp Position Number: 64801367… more
- Office of the Inspector General (Billings, MT)
- …and program reviews in support of the unit's mission. As a Criminal Investigator (Special Agent) you will conduct complex and difficult, highly visible or sensitive ... civil and administrative investigative techniques, complex fraud schemes, civil false claims and allegations of DOI violations and other crimes. The selected… more
- City of Pittsburgh (Pittsburgh, PA)
- …to the assigned attorney/ claims manager. + Reviews contracts, medical records and financial reports or other files as needed. + Conducts site visits and scene ... Investigator , Law Print (https://www.governmentjobs.com/careers/pittsburgh/jobs/newprint/4432809) Apply Investigator , Law Salary See Position Description… more
- State of Minnesota (St. Paul, MN)
- …_Experience working with or for a Managed Care Organization._ _._ _Analyze claims data, provider documentation, financial records, and other restricted recipient ... **Working Title: Lead Restricted Recipient Senior Investigator ** **Job Class: Human Services Program Consultant** **Agency: Human Services Dept** + **Job ID** :… more
- Highmark Health (Harrisburg, PA)
- …affiliated companies and work with Finance to ensure proper recording the financial statements. + Conduct audits for proactive and investigative purposes to comply ... varying size and complexity **Preferred** + 3 years of financial analysis in an acute care hospital or health...+ Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- Universal Health Services (Reno, NV)
- …facilities, and members. This position researches, gathers, and analyzes claims data, medical records, corporate policy, state/federal policy, and practice ... field + The following certifications are preferred: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), and Certified Professional Coder… more
- BAE Systems (Falls Church, VA)
- …to Have: o Fluent in Spanish o Experience working on EEO claims /matters o Experience drafting position statements **Pay Information** Full-Time Salary Range: $113080 ... our employees in all aspects of their life, including their health and financial well-being. Regular employees scheduled to work 20 hours per week are offered:… more
- US Bank (Fargo, ND)
- …best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We ... excel at-all from Day One. **Job Description** Responsible for claims and disputes intake, review, and/or disposition of potentially...you and your family boost your health, protect your financial security and give you peace of mind. Our… more
- Aerotek (Tempe, AZ)
- …attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims ; negotiates with TPA the settlement of ... **Overview:** **Aerotek has an immediate opening for a Claims Review Specialist - Workers Compensation at the...vendors such as defense attorneys, nurse case managers and investigator + Coordinates the employee's release to transitional duty… more
- The Mount Sinai Health System (New York, NY)
- …all insurance assessment forms and agreements and ensures they are accurate for claims processing. 8. Prepares, collects and analyzes financial stats on all ... science. Advancing medicine. Healing made personal. **_Roles & Responsibilities:_** The Financial Authorization Associate I is responsible for the admitting and … more
- CareFirst (Baltimore, MD)
- …from internal and external data bases and systems to support leads. Analyzes detailed claims files and performs financial calculations to assess financial ... of fraud and/or abuse theory approach analyses, provider and subscriber medical data, claims , and systems reports as required. + Performs root cause analysis to… more