- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, ... who will oversee the monitoring and enforcement of the fraud , waste , and abuse (FWA) compliance program...areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities… more
- Health Care Service Corporation (Richardson, TX)
- …* Experience with fraud waste and abuse * Accredited Health Care Fraud Investigator * Certified Professional Coder * Certified Fraud Examiner Please ... controls and protocols, and recommends enhancements to reduce the potential for fraud . **JOB REQUIREMENTS:** * Bachelor's Degree **OR** 4 years of investigative… more
- State of Massachusetts (Boston, MA)
- …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 public property. ... functions. Together the bureaus work to prevent and detect waste , fraud and abuse of public resources...appropriate agency if it falls outside our jurisdiction. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- Molina Healthcare (Nampa, ID)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- State of Massachusetts (Boston, MA)
- …. ** INVESTIGATOR I, INVESTIGATOR II, and INVESTIGATOR III ** ** HEALTHCARE&FAIRCOMPETITIONBUREAU MEDICAID FRAUD DIVISION AttorneyGeneralAndrea ... Joy Campbell isseekinghighlymotivatedcandidatestojoinherteamintheroleof Investigator in the Medicaid Fraud Division.We are currently seeking candidates with a range… more
- MyFlorida (Jacksonville, FL)
- …the Bureau of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... FINANCIAL CRIME INVESTIGATOR I (PENDING RECLASSIFICATION) - 43061920 Date: Oct 2, 2025 The State Personnel System is an E-Verify employer. For more information click… more
- MyFlorida (Fort Lauderdale, FL)
- …of Financial Services. This advertisement is for the Bureau of Public Assistance Fraud . This advertisement is for aFinancial Crime Investigator Iposition which ... FINANCIAL CRIME INVESTIGATOR I - 43061893 Date: Sep 30, 2025... Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the… more
- Highmark Health (Montgomery, AL)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… more
- CVS Health (Workman, MN)
- …to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste , and abuse. Also reports suspected fraud , ... Conducts investigations of known or suspected acts of healthcare fraud , waste , and abuse - Communicates with...in Employee Competencies - Exhibits behaviors outlined in SIU Investigator Competencies - May include travel to testify in… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
- CVS Health (Charleston, WV)
- …+ Bachelor's degree or equivalent experience (3-5 years of working health care fraud , waste and abuse investigations). **Anticipated Weekly Hours** 40 **Time ... every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known or… more
- Providence (Oakland, CA)
- …software/tools. **Preferred Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an ... **Description** ** Investigator External Audit Special Investigations Unit \*Remote The...to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan… more
- MTA (New York, NY)
- …will participate in and conduct confidential and sensitive investigations regarding allegations of fraud , waste and abuse or other corrupt activities that may ... Investigator Job ID: 12606 Business Unit: MTA Inspector...+ Conduct high-quality, complex, comprehensive, investigations into allegations of fraud , waste , and abuse by the MTA… more
- Aramco Services Company (Houston, TX)
- …be completed. + Conducts objective, thorough, and timely investigations into allegations of fraud , waste or abuse committed by employees or contractors against ... assignments beyond the normal scope of the audit function. The Senior Lead Investigator handles hotline reports or calls and manages cases of moderate to high… more
- New York State Civil Service (New York, NY)
- …will participate in and conduct confidential and sensitive investigations regarding allegations of fraud , waste and abuse or other corrupt activities that may ... reports.Duties and Responsibilities:* Conduct high-quality, complex, comprehensive, investigations into allegations of fraud , waste , and abuse by the MTA and its… more
- City of New York (New York, NY)
- …of clean drinking water for New Yorkers. DOI is seeking a Confidential Investigator who will be responsible for investigating fraud , corruption, and ... will be responsible for the investigation of matters involving fraud , waste and abuse related to the...of Management & Budget approval for budgeted headcount. CONFIDENTIAL INVESTIGATOR - 31143 Qualifications 1. A four-year high school… more
- CVS Health (OK)
- …- Must be located in Oklahoma. - 1+ years experience working in healthcare fraud , waste and abuse investigations and audits. - Experience reviewing and analyzing ... equivalent experience with two additional years working in health care fraud , waste , and abuse investigations and audits. **Anticipated Weekly Hours** 40 **Time… more
- Centene Corporation (Frankfort, KY)
- …systems to assure integrity and compliance in billing and claims payment + Investigate possible waste , abuse and fraud leads and document activity on each lead ... to the appropriate party + Develop internal reports to identify potential waste , abuse and fraud + Perform data mining and analysis to detect aberrancies and… more
- Parsons Corporation (Springfield, VA)
- …disaster recovery operations.** . **What You'll Be Doing:** + Investigate complaints of fraud , waste and abuse, data spills, and network penetrations. + Respond ... Parsons is looking for an amazingly talented **Insider Threat Investigator ** to join our team! In this role you...of fraudulent recruitment practices. To learn more about recruitment fraud and how to report it, please refer to… more
- Centene Corporation (Sacramento, CA)
- …and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste , abuse, and fraud + Document activity on each case and refer ... in claims + Develop new queries and reports to detect potential waste , abuse, and fraud + Provide case updates on progress of investigations and coordinate with… more
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