• Clinical Fraud Investigator II

    Elevance Health (Mason, OH)
    **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... dynamic and adaptable workplace. Alternate locations may be considered. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
    Elevance Health (05/31/25)
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  • Director Complex Claims

    Sedgwick (Toledo, OH)
    …university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), or Certified Fraud Examiner (CFE) strong ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for managing SIU investigations… more
    Sedgwick (05/08/25)
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  • Investigator

    Highmark Health (Columbus, OH)
    …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... This job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training...facility payment methodology, claims processing systems and coding and billing proficiency +… more
    Highmark Health (05/08/25)
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  • Investigator , SIU RN-Remote

    Molina Healthcare (OH)
    **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review… more
    Molina Healthcare (04/12/25)
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  • Investigator II

    Elevance Health (Mason, OH)
    ** Investigator II** **Location Hybrid 1** : This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while ... dynamic and adaptable workplace. Alternate locations may be considered. The ** Investigator II** is responsible for the identification, investigation and development… more
    Elevance Health (05/31/25)
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  • Investigator II

    Elevance Health (Columbus, OH)
    ** Investigator II** **Supporting the Payment Integrity line of business** _Location:_ **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator II** is responsible for the identification, investigation and development… more
    Elevance Health (05/30/25)
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  • Investigator Senior

    Elevance Health (Columbus, OH)
    ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
    Elevance Health (05/23/25)
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  • Medical Science Liaison- CNS Houston

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …Otsuka's clinical trials program, including registrational, post-marketing and Investigator -Sponsored Trials (ISTs), health economic outcomes research, other ... contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
    Otsuka America Pharmaceutical Inc. (05/17/25)
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  • Director, Quantitative Pharmacology, Clinical…

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …pharmacology** sections for regulatory filings, including annual reports, investigator 's brochure, IND/NDA/BLA applications and pediatrics development plans in ... contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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