- Dexian - DISYS (Baltimore, MD)
- …of losses through the detection, investigation, and resolution of low to medium levels fraud , waste , and abuse schemes, resulting in the savings and ... to all levels (low to medium) investigations of suspected fraud , waste , and abuse . In...health care or investigations related area such as Certified Fraud Examiner (CFE),Accredited Health Fraud Investigator… more
- nTech Solutions, Inc. (Baltimore, MD)
- …of losses through the detection, investigation, and resolution of low to medium levels fraud , waste , and abuse schemes orchestrated by providers, members, ... an assigned team to all levels (low to medium) investigations of suspected fraud , waste , and abuse . In conjunction with assigned team or management, develop… more
- Geisinger (Danville, PA)
- …Job Duties Conducts investigations and research relating to preventing, detecting and correcting fraud , waste and abuse in all lines of business. ... Salary would commensurate with experience. Position Details Preferred Certification(s) -Certified Fraud Examiner -Accredited HealthCare Fraud Investigator … more
- Humana (Baton Rouge, LA)
- …hours/day, 5 days/week. **Required Qualifications** + **Must reside in Louisiana** + Healthcare fraud , waste , and abuse investigations experience + Knowledge ... put health first** Humana Healthy Horizons in Louisiana is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
- Humana (Oklahoma City, OK)
- …on business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste , and abuse investigations experience + Knowledge of ... put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
- Amazon (Arlington, VA)
- …and uses signals in transactional data such as invoices and payments as indicators of theft, fraud , waste or abuse . We are looking for a technical minded ... Amazon is seeking a data-driven, highly motivated and organized Investigator and Risk Manager of Corporate Fraud ...in Finance Operations with the ultimate goal of preventing fraud , waste , and abuse across… more
- State of Michigan (MI)
- …Oakland, and Wayne Counties This Regulation Agent position will conduct investigations of fraud , waste or abuse by recipients, non-Medicaid providers and ... Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb,...No 13 Do you have any substantiated cases of abuse or neglect reported on the Department of Health… more
- Molina Healthcare (Omaha, NE)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse . Duties include performing accurate and ... to the SIU to assess and determine whether potential fraud , waste , or abuse is...Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud… more
- State of Massachusetts (Boston, MA)
- …public money and property. The OIG is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public funds and ... functions. Together the bureaus work to prevent and detect waste , fraud and abuse of...when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- Highmark Health (Harrisburg, PA)
- …for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, ... to complete a review of a special project, potential fraud , waste and abuse case,...(CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have… more
- Office of Inspector General (Raleigh, NC)
- Summary This office works within DOT to detect and prevent waste , fraud and abuse in departmental programs. The OIG reports to the Secretary and Congress and ... for planning, directing and conducting complex investigations of suspected fraud , waste , and abuse , and...have in the past worked as a GS-1811 Criminal Investigator in a federal OIG office must clearly demonstrate… more
- AmeriHealth Caritas (Washington, DC)
- …+ Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of ... **Special Investigator Managed Care - DMV Counties only** Location:...potential fraud , waste and / or abuse with a... fraud , waste and / or abuse with a focus on thoroughness and attention to… more
- CVS Health (Springfield, IL)
- …information EDUCATION: *Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay ... will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse . Routinely handles cases that are sensitive or high… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …(SIU), the ** Investigator III** will be responsible for investigating allegations of external fraud , waste , and abuse (FWA). The reports prepared by this ... Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in auditing and… more
- MyFlorida (Tallahassee, FL)
- …the Division of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded ... FINANCIAL CRIME INVESTIGATOR I (PENDING RECLASSIFICATION)- 43061929 Date: Apr 15, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify… more
- CVS Health (Richmond, VA)
- …Department of Medical Assistance Services- 3 years in healthcare field working in fraud , waste and abuse investigations and audits.- Strong analytical ... and/or an Associate's degree with three additional years working in health care fraud , waste , and abuse investigationsand audits. Pay Range The typical pay… more
- Office of the Inspector General for Tax Administration (New York, NY)
- …negatively impact the IRS' ability to administer the nation's tax laws. We detect and deter waste , fraud and abuse in IRS programs and operations and protect ... of a group's investigative program and assigned resources. This program investigates allegations of fraud , abuse , or misconduct by employees of the IRS and the… more
- Commonwealth Care Alliance (Boston, MA)
- … Investigator works with a growing team conducting and managing Health Care Fraud , Waste and Abuse investigation and prevention activities under the ... management reports. + Knowledge of federal and state laws and regulations pertaining to fraud , waste and abuse . + Desire to work in a collaborative and… more
- Point32Health (Canton, MA)
- …team member of the SIU, responsible for leading complex provider investigations related to fraud , waste and abuse , and developing action plans to address ... the investigative findings and prevent future loss. The Investigator works closely with other members of the SIU...monitor provider activity post-investigation + Identifying root causes of fraud , waste and abuse and… more
- CVS Health (Columbus, OH)
- …Competencies Required Qualifications + Minimum three years in healthcare field working in fraud , waste and abuse investigations and audits utilizing ... to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and to comply with state regulations… more
