- 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 ... Office for the Eastern District of North Carolina. The investigator will be assigned cases and matters that vary...of data relating to suspected civil violations, such as healthcare fraud or other violations or offenses… more
- Gilead Sciences, Inc. (Foster City, CA)
- …live or their economic status. **About the Role** The global pharmaceutical crime and healthcare fraud market is currently estimated at $400 billion annually. It ... lead and accelerate the development of the group's pharmaceutical crime and healthcare fraud program. The role will include both people leadership and individual… more
- Geisinger (Danville, PA)
- …experience. Position Details Preferred Certification(s) -Certified Fraud Examiner -Accredited HealthCare Fraud Investigator Education High School Diploma ... nursing and / or health care investigation experience, Certified Fraud Examiner, National Health Care Anti- Fraud Association...patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions… more
- Highmark Health (Harrisburg, PA)
- …+ Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge ... **EXPERIENCE** **Required** + 5 years in the Health insurance industry and/or Healthcare fraud investigations + 1 year of leading projects of varying size and… more
- Universal Health Services (Reno, NV)
- …data analytics or related field + The following certifications are preferred: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner ... Unit is responsible for investigating and resolving high complexity healthcare fraud , waste and abuse (FWA) by medical professional, facilities, and… more
- MyFlorida (Miami, FL)
- …related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified Financial Crimes ... (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging...Investigator ; Certified Insurance Fraud Investigator ; or Certified Compliance and Ethics… more
- MyFlorida (Tallahassee, FL)
- …related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified Financial Crimes ... Investigator ; Certified Insurance Fraud Investigator ; Certified Professional Compliance Officer, or Certified Program Integrity Professional. LICENSURE,… more
- Highmark Health (Columbus, OH)
- …+ Certified Professional Coder- Hospital(CPC-H) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have ... graphs, and charts to timely identify trends and patterns of potential healthcare fraud , waste and abuse. Communicate findings to company management of various… more
- State of Georgia (Fulton County, GA)
- Investigator - Medicaid Fraud Division Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/37043/other-jobs-matching/location-only) Hot ... this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud … more
- Umpqua Bank (Tigard, OR)
- Senior Fraud Investigator Corporate Risk Tigard, Oregon **Description** **About Us:** Umpqua Bank is headquartered in the Pacific Northwest with 5,000+ employees ... Teamwork, Heart, Enjoyment, and Relationships. **About the Role:** Investigate potential fraud identified. + Partners with store managers, associates and various… more
- Humana (Oklahoma City, OK)
- …on business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste, and abuse investigations experience + Knowledge of ... first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of... healthcare payment methodologies + Strong organizational, interpersonal, and communication… more
- US Bank (Fargo, ND)
- …include the following (some may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional term life insurance + ... Short-term and long-term disability + Pregnancy disability and parental leave + 401(k) and employer-funded retirement plan + Paid vacation (from two to five weeks depending on salary grade and tenure) + Up to 11 paid holiday opportunities + Adoption assistance… more
- Molina Healthcare (Omaha, NE)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- MyFlorida (Fort Lauderdale, FL)
- …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... LAW ENFORCEMENT INVESTIGATOR II - 41001279 Date: May 8, 2024...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in ... Work and Improve People's Lives** Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working… more
- CVS Health (Springfield, IL)
- … you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high ... cases involving multi-lines of business, or cases involving multipleperpetrators or intricate healthcare fraud schemes * Investigates to prevent payment of… more
- State of Georgia (Fulton County, GA)
- …Georgia Medicaid Program. Participates as a member of an interdisciplinary team in Healthcare fraud investigations, and provides support to members of other ... of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward...eligibility of providers as requested. + Assists prosecutors in Healthcare Fraud investigations by reviewing provider and… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …approach to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4500803) Apply ...cyber crimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud … more
- CVS Health (Tallahassee, FL)
- …Components: - Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - Routinely handles cases that are sensitive ... multi-disciplinary provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of… more
- CVS Health (Columbus, OH)
- …+ Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... and practices. + Conducts investigations of known or suspected acts of healthcare fraud and abuse + Communicates with federal, state, and local law enforcement… more
Related Job Searches:
Fraud,
Fraud Investigator,
Healthcare,
Healthcare Fraud,
Investigator,
Senior Healthcare Fraud Investigator