- Dexian - DISYS (Baltimore, MD)
- …or investigations related area such as Certified Fraud Examiner (CFE),Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional ... Unit. Qualifications:Education Level: Bachelor's DegreeExperience: 2 years insurance, investigative, health care , nursing or law enforcement. In lieu… more
- Molina Healthcare (Omaha, NE)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud ... reporting, and when appropriate, recovery of money related to health care fraud , waste, and...on allegations of FWA and/or may determine appropriateness of care . The SIU Investigator is also responsible… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Nurse (RN), Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) ... a member of Premera's Special Investigations Unit (SIU), the ** Investigator III** will be responsible for investigating allegations of... Examiners (ACFE) to keep apprised of developments in health care fraud . **What you'll… more
- Geisinger (Danville, PA)
- …are quick learners. Preferred backgrounds are: Bachelors degree, nursing and / or health care investigation experience, Certified Fraud Examiner, National ... Health Care Anti- Fraud Association accreditation. Job Duties Conducts investigations and research relating to preventing, detecting and correcting fraud ,… more
- CDPHP (Albany, NY)
- …year of employment. + Certified Outpatient Coder (COC) Certification is preferred. + Accredited Health Care Fraud Investigator (AHFI(R)) accreditation to ... action to resolve and prevent any occurrences. The Analyst will present findings to health care providers and negotiate resolution of issues. They will be… more
- New York State Civil Service (New York, NY)
- …prior experience in conducting insurance fraud , particularly with a workers' compensation/ health care fraud context, and/or with prior insurance ... HELP No Agency State Inspector General, Office of Title Workers' Compensation Fraud Investigator Occupational Category Enforcement or Protective Services Salary… more
- State of Georgia (Fulton County, GA)
- …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... Investigator - Medicaid Fraud Division Georgia...limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient… more
- SGI Global, LLC (Raleigh, NC)
- …to potential civil actions within the jurisdiction of the USAO-EDNC involving opioid-related health care fraud violations. + Working with assigned Assistant ... SGI Global is seeking a Civil Investigator (Healthcare Fraud and Opioid Matters)...with or in the areas of medicine, medical practices, health care , pharmaceuticals, pharmacies, and/or pharmacy operations… more
- Gilead Sciences, Inc. (Foster City, CA)
- …across the globe. We continue to fight against the world's biggest health challenges, and our mission requires collaboration, determination and a relentless drive ... of unmet medical need. The company's mission is to advance the care of patients suffering from life-threatening diseases worldwide. Headquartered in Foster City,… more
- Humana (Oklahoma City, OK)
- …we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These ... part of our caring community and help us put health first** Humana Healthy Horizons in Oklahoma is seeking...first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of… more
- State of Colorado (Denver, CO)
- Criminal Investigator II (Special Prosecutions) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4441274) Apply Criminal Investigator II ... is currently offering a sign-on bonus for new criminal investigator hires of $2,000. Sign-On bonuses will be paid...to protecting the people of Colorado with integrity and care . In this role, you will have the opportunity… more
- Ventura County (Ventura, CA)
- District Attorney Investigator I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4165939) Apply District Attorney Investigator I/II ... for prosecution. The Bureau is staffed with a chief investigator , a deputy chief investigator , 3 commanders,...wide range of investigations from homicide to complex white-collar fraud schemes. The Bureau of Investigation has three divisions:… more
- MyFlorida (Miami, FL)
- FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004823 Date: Apr 25, 2024 Location: MIAMI, FL, US, 33101 The State Personnel System is an E-Verify employer. For more ... No: 825559 Agency: Office of Financial Regulation Working Title: FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004823 Pay Plan: Career Service Position Number:… more
- AmeriHealth Caritas (Washington, DC)
- …and sequential thinker. + A minimum of 3-5 years experience conducting comprehensive health care fraud investigations; interacting with state, federal and ... **Special Investigator Managed Care - DMV Counties...starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're… more
- Veterans Affairs, Veterans Health Administration (Battle Creek, MI)
- …influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 ... Creek VA Medical Center is recruiting for a Criminal Investigator . The Criminal Investigator will function under...(COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel… more
- MyFlorida (Fort Lauderdale, FL)
- …of patients, investigate the alleged misappropriation of patients private funds in health care facilities. This is independent work conducting investigations of ... LAW ENFORCEMENT INVESTIGATOR II - 41001279 Date: May 8, 2024...Annually Position Summary: This position is in the Medicaid Fraud Unit. The Attorney General's Medicaid Fraud … more
- CVS Health (Springfield, IL)
- …to research information EDUCATION: *Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The ... of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti- Fraud Association (AHFI)*Knowledge of Aetna's policies and… more
- Highmark Health (Harrisburg, PA)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... related field **EXPERIENCE** **Required** + 5 years in the Health insurance industry and/or Healthcare fraud investigations...+ 3 years of financial analysis in an acute care hospital or health insurance setting +… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …is a state law enforcement agency, and it's mission is to investigate and prosecute health care providers who have defrauded the Medicaid program. The MFCU also ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4500803) Apply ...prosecutes allegations of abuse, and neglect of residents in health care facilities. The MFCU utilizes a… more
- The County of Los Angeles (Los Angeles, CA)
- …investigation of various types of fraud (eg, auto insurance, workers' compensation, health care , real estate, and consumer). You may also work directly with ... INVESTIGATOR , DA Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2434815) Apply INVESTIGATOR , DA Salary $79,495.68 - $107,128.32 Annually… more
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