- Allied Universal (Charleston, WV)
- …for most full-time compliance and investigation jobs! Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate ...Law Specialist (FCLS) + Certified Protection Professional (CPP) + Associate in Claims (AIC) + Chartered Property… more
- Allied Universal (Crossville, TN)
- …compliance and investigation jobs! Allied Universal(R) is hiring a SIU / Claims Investigator . Special Investigations Unit (SIU) Specialists investigate claims ... Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate ...Law Specialist (FCLS) + Certified Protection Professional (CPP) + Associate in Claims (AIC) + Chartered Property… more
- Allied Solutions (Plano, TX)
- …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...assigned + Obtain adjuster licenses as needed Qualifications: + Associate college degree required except in the following circumstances:… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of the Fraud, Waste & Abuse (FWA) ... and other CCA departments related to review processes and results. Sr Associate , FWA Investigator Coder utilizes claim analysis, document review, coding… more
- Commonwealth of Pennsylvania (PA)
- Third Party Liability Program Investigator Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4510578) Apply Third Party Liability Program ... Investigator Salary $49,839.00 - $75,795.00 Annually Location Dauphin County,...relevant parties of DHS interest, initiate requests of medical claims for review, and follow up to ensure payment… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Associate Investigator works with a growing team conducting and managing Health Care Fraud, Waste and Abuse ... mining and visualization programs to design queries and analyze claims data to detect outliers or suspicious patterns for...+ At least three (3) years of related investigative, claims , compliance or analyst experience in healthcare, data reporting… more
- CDPHP (Albany, NY)
- …and invites you to be a part of that experience. The SIU Special Investigator will be responsible for investigating complex insurance cases to detect internal and ... external fraud and abuse. The Special Investigator will research and document cases utilizing resources available...below, in line with New York State requirements: + Associate 's or Bachelor's degree in criminal justice or related… more
- System One (Baltimore, MD)
- ALTA IT is hiring an Associate Investigator to support a leading health insurance customer. The individual will work with the Special Investigations Unit (SIU) ... Baltimore, MD (Hybrid) twice a week Job Duties: + Research provider/subscriber claims activity, operations manuals, data systems, medical policies, job duties and… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: The Equal Employment Opportunity and Title IX Investigator (EEO/Title IX Investigator ) serves as part of a team investigating and resolving ... the University's legal obligations to address discrimination and harassment claims and sexual misconduct. Document findings as to the...for Equity and Inclusion and Chief Diversity Officer and Associate VP for Equity & Inclusion and Sr. … more
- Molina Healthcare (Omaha, NE)
- …related work. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : + Health Care Anti-Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- City of New York (New York, NY)
- …in their agreement to repay. Claims &Collection is recruiting for (4) four Fraud Investigator II to function as a Senior Fraud Investigator , who will: - Send ... Job Description Claims and Collections pursues monetary recoveries owed to...nature involving public or private funds; or 2. An associate degree or 60 semester credits from an accredited… more
- Independent Health (Buffalo, NY)
- …benefits and commitment to diversity and inclusion. **Overview** The Fraud Investigator develops, implements and administers the IH anti-fraud program, including a ... functional fraud control owners to ensure overall program effectiveness. This associate will also be responsible for investigating suspected fraudulent or abusive… more
- AmeriHealth Caritas (Washington, DC)
- **Special Investigator Managed Care - DMV Counties only** Location: Washington, DC Primary Job Function: Compliance ID**: 29509 **Job Brief** This position will work ... services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Investigator is responsible for conducting comprehensive investigations of reported,… more
- City of Pittsburgh (Pittsburgh, PA)
- Investigator , Law Print (https://www.governmentjobs.com/careers/pittsburgh/jobs/newprint/4432809) Apply Investigator , Law Salary See Position Description ... + EDUCATION/TRAINING : The application must clearly show a minimum of an Associate 's degree from a fully accredited institution in Human Resources, Administration of… more
- Aflac (GA)
- …designations/certifications: Fraud Claims Law Specialist (FCLS), Health Care Anti-Fraud Associate (HCAFA), or Certified Insurance Fraud Investigator (CIFI) + ... Investigator I (Bilingual Preferred) The Company: Aflac Columbus The Location: GA, US, 31999 The Division: Compliance Job Id: 6317 Salary Range: $42,000 - $98,000… more
- City of New York (New York, NY)
- …Safety seeks to hire an Environmental, Health and Safety Incident/Workplace Violence Investigator located in Flushing, New York. Under general direction, but with ... selected candidate will be responsible for the following: 1) As a lead Investigator or part of an investigation team conduct investigations into incidents such as… more
- CVS Health (Richmond, VA)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... Knowledge of Aetna's policies and procedures.Education - Bachelor's degree and/or an Associate 's degree with three additional years working in health care fraud,… more
- CVS Health (Trenton, NJ)
- …healthcare fraud cases.- Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc.- Facilitates ... Knowledge of Aetna's policies and proceduresEducation - Bachelor's degree and/or an Associate 's degree with three additional years working in health care fraud,… more
- Humana (Oklahoma City, OK)
- …CCS, CFE, AHFI) + Analytical background + Understanding of healthcare industry, claims processing and investigative process development + Experience in a corporate ... (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Boehringer Ingelheim (St. Joseph, MO)
- …Boehringer Ingelheim's high regard for our employees. The Senior Clinical Research Associate (SCRA) conducts in-house and external monitoring to verify that reported ... of study protocols, raw data, and reports to support registrations and other claims related to veterinary products. The SCRA performs these duties for on-site and… more