- AAOS (Rosemont, IL)
- …acts as back up for contract management system in the absence of the Legal Operations Associate . Assists with any pending litigation matters where AAOS is a ... (eg, HIPAA, HITECH). Oversees the contract administration activities of the Legal Operations Associate . Serves on the Business Leadership Group and IT… more
- Citizens (Medford, MA)
- …a Fraud Claims Sr. Specialist, you'll play a pivotal role in our Fraud and Claims Operations group, one of our most critical departments at Citizens. ... + Review Claims - Responsible for reviewing claims filed by customers for fraud and...in the banking industry, including an understanding of banking operations , compliance, and customer service best practices. + Workflow… more
- EverBank (Irvine, CA)
- … operations processes + Experience with the recovery rights for various types of fraud , EFT claims and wire recalls processing. + Knowledge of regulations (ie ... **Bank Fraud Analyst II** The Bank Fraud ...disclosed their own pay or the pay of another associate or applicant. However, associates who have access to… more
- Regions Bank (Hoover, AL)
- …**Job Description:** At Regions, the Financial Crimes Fraud Specialist monitors fraud prevention reports and/or reviews and resolves claims to address ... or other bank products + Identifies valid and fraudulent charges, sets up fraud files, uses multiple research techniques to resolve issues, reconciles and summarizes… more
- Humana (Oklahoma City, OK)
- …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 ... abusive practices. The Fraud and Waste Professional 2 work assignments are varied...AHFI) + Analytical background + Understanding of healthcare industry, claims processing and investigative process development + Experience in… more
- Raymond James Financial, Inc. (Pittsburgh, PA)
- …institutional, and high-net-worth (HNW) clients.** **Job Summary:** The Senior Wire Operations Associate will deliver high quality customer service and ... time sensitive operations environment. The Senior Wire Operations Associate will conduct all aspects of...status queues. The incumbent will also be responsible for fraud monitoring and investigation, working closely with internal and… more
- DXC Technology (Lansing, MI)
- …(NYSE: DXC) helps global companies run their mission critical systems and operations while modernizing IT, optimizing data architectures, and ensuring security and ... for our customers and colleagues at DXC.com **Job Description** **:** The Associate Manager of Software Engineering is a highly skilled, self-driven servant leader… more
- System One (Baltimore, MD)
- …Baltimore, MD (Hybrid) twice a week Job Duties: + Research provider/subscriber claims activity, operations manuals, data systems, medical policies, job duties ... ALTA IT is hiring an Associate Investigator to support a leading health insurance...losses. You will research and analyze data using company anti- fraud software, Excel, and other tools to proactively identify… more
- Walmart (Semmes, AL)
- …training. Determines training needs. Develops and delivers training as needed. Manages claims and receiving operations by ensuring proper policies and procedures ... and collaborating with all levels of associates regarding store operations , utilizing technology, business initiatives, merchandising, and company direction;… more
- Walmart (Hayward, WI)
- …training needs; and developing and delivering the training where needed. Manages claims and receiving operations by ensuring proper policies and procedures ... violations of company policies and criminal activities by investigating alleged fraud and other alleged illegal activities; conducting investigations relating to the… more
- Wells Fargo (Westlake, TX)
- …scalability, and security for Wells Fargo. Services include deposits, payments and ATM operations , global fraud and claims , account reconciliation, cash ... benefits package. Apply today. **About this role:** Wells Fargo is seeking an Associate Customer Service Representative in **Everyday Banking** . Find out why we're… more
- CareFirst (Baltimore, MD)
- …billing and/or other related systems and procedures to determine the integrity of claims payments and business operations within CareFirst or previous experience ... and external data bases and systems to support leads. Analyzes detailed claims files and performs financial calculations to assess financial impact of potential… more
- Walmart (Macclenny, FL)
- …Consults on complex claims and settlements. Designs preventative claims management processes (for example, associate engagement efforts, return-to-work ... or More Certifications such as Loss Prevention Certification (LPC), Certified Fraud Examiner (CFE), Associate Safety Professional; Certified Safety Professional;… more
- State of Massachusetts (Boston, MA)
- * Claims Examiner/Job Service Representative I| Department of Family & Medical Leave* The Program Integrity Claims Examiner/Job Service Representative I is ... within the Department of Family Medical Leave (DFML). The Claims Examiner/Job Service Representative I will review claims...I, who reports to the Senior Manager of Benefit Operations & Program Integrity is based in Boston, MA,… more
- Millennium Challenge Corporation (District Of Columbia, DC)
- …position is located in the in the Program Financial Services Unit, Sector Operations Division within the Department of Compact Operations , Millennium Challenge ... to implement the program. Ensuring that measures to prevent fraud , waste and abuse are implemented. Coordinating with the...closing date of the announcement. Please note that qualification claims will be subject to verification. Pay: Your pay… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …controls and policies and procedures for both acute and provider Revenue Cycle operations including the development of SOPs. + Develops acute and provider compliance ... Office of Inspector General (OIG), Medicare, State Medicaid, State Insurance Fraud , Managed Care or Governmental Value-Based payment programs or other enforcement… more
- Beth Israel Lahey Health (Burlington, MA)
- …and Revenue Cycle Leadership. 2. Responsible to advise and assist with revenue operations as they relate to Epic build decisions, in-depth analysis of denials, ... appeals, audits, credits, cash, coding, workflows, data collection, report details, claims and remittance set up, logic and processing and applicable technical… more
- Burrell Behavioral Health (Springfield, MO)
- …reports, and overseeing audit coordination. You'll investigate suspect billing practices, analyze claims data for potential fraud , waste, and abuse patterns, and ... billing for Federal health care program overpayments + Analyze claims data for potential fraud , waste, and...+ While performing the duties of this job, the associate is frequently required to sit and stand for… more
- MAPFRE Insurance (Webster, MA)
- …Ensure timely and comprehensive responses to complaints with supervisory oversight. + Fraud Identification - Identify potentially fraudulent claims for transfer ... Claim Rep, you will be responsible for adjusting 1st party Express claims for Auto Physical Damage through screening losses, determining coverage exposures, and… more
- Walmart (Bentonville, AR)
- …process to consistently protect the company's interests, with regards to claims management). Maintain and continuously improve operations standards. Gauge ... on the most significant problems to maximize efficiency gains. Measure standardized operations ; find inefficiencies caused due to systems, tools, processes and work… more
