- Geisinger (Danville, PA)
- …Salary would commensurate with experience. Position Details Preferred Certification(s) -Certified Fraud Examiner -Accredited HealthCare Fraud Investigator ... investigations and research relating to preventing, detecting and correcting fraud , waste and abuse in all lines...a combination of related work experience and degree obtained ( Associate 's Degree = 2 years; Bachelor's Degree = 4… more
- Humana (Baton Rouge, LA)
- …5 days/week. **Required Qualifications** + **Must reside in Louisiana** + Healthcare fraud , waste, and abuse investigations experience + Knowledge of healthcare ... us put health first** Humana Healthy Horizons in Louisiana is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… more
- Humana (Oklahoma City, OK)
- …business needs. **Required Qualifications** + **Must reside in Oklahoma** + Healthcare fraud , waste, and abuse investigations experience + Knowledge of ... us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and… 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 ... and data analysis to identify, evaluate and measure potential healthcare fraud and abuse to determine valid cases for appropriate action. + Document and… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, physicians, ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4372786) Apply ...cyber crimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud … more
- AmeriHealth Caritas (Washington, DC)
- …Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of potential ... **Special Investigator Managed Care - DMV Counties only** Location:... fraud , waste and / or abuse with a focus on thoroughness and attention to… more
- CVS Health (Richmond, VA)
- …Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, and to comply ... plans and practices.- Conducts investigations of known or suspected acts of healthcare fraud and abuse .- Communicates with federal, state, and local law… more
- CareFirst (Baltimore, MD)
- …Qualifications:** Credentials as Certified Fraud Examiner (CFE), Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional Coder (CPC). ... sources for statistical purposes and enter cases accurately in Fraud , Waste and Abuse case management system....indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of… more
- City of New York (New York, NY)
- …administered by HRA/DSS and NYSDOH. BFI investigates active and closed cases suspected of fraud and abuse based on computer match data and allegations received ... The Investigation, Revenue and Enforcement Administration includes the Bureau of Fraud Investigation (BFI). BFI, as mandated by Social Service Law, conducts… more
- CDPHP (Albany, NY)
- …Certified Outpatient Coder (COC) Certification is preferred. + Accredited Health Care Fraud Investigator (AHFI(R)) accreditation to be obtained once the required ... civil or other recovery action on the basis of fraud , waste, or abuse . QUALIFICATIONS: + Registered...valid New York State registration or license required. + Associate 's degree or two (2) years of equivalent experience… more