- Geisinger (Danville, PA)
- …Salary would commensurate with experience. Position Details Preferred Certification(s) -Certified Fraud Examiner -Accredited HealthCare Fraud Investigator ... investigation experience, Certified Fraud Examiner, National Health Care Anti- Fraud Association accreditation. Job Duties Conducts investigations and… more
- CVS Health (Springfield, IL)
- …will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high ... multi-lines of business, or cases involving multipleperpetrators or intricate healthcare fraud schemes * Investigates to prevent...or an additional 5 years of working health care fraud , waste and abuse investigations . Pay Range… more
- CVS Health (Tallahassee, FL)
- …- Conducts high level, complex investigations of known or suspected acts of healthcare fraud and abuse. - Routinely handles cases that are sensitive or high ... provider groups, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent...in identifying resources and best course of action on investigations . - Serves as back up to the Team… more
- Prime Therapeutics (Columbus, OH)
- …conclusions and recommendations. MISCELLANEOUS DUTIES: + Provide backup support to team members ( SIU Coordinator and Senior SIU Specialist) in the ... to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general...in behavioral health, radiology or pharmacy. + 3+ years' fraud investigations /claims experience. + Ability to manage… more