- Dexian - DISYS (Baltimore, MD)
- …in a health care or investigations related area such as Certified Fraud Examiner (CFE),Accredited Health Fraud Investigator (AHFI), RN/LPN, ... of losses through the detection, investigation, and resolution of low to medium levels fraud , waste , and abuse schemes, resulting in the savings and recovery of… more
- Humana (Oklahoma City, OK)
- …Professional 2 who conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied ... begin your future with a Fortune 40 Company! The Fraud and Waste Professional 2: + Coordinates...linkages to related areas + Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal… more
- State of Michigan (MI)
- Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland, Wayne Co Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/3739587) Apply ... Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland,...Counties This Regulation Agent position will conduct investigations of fraud , waste or abuse by recipients, non-Medicaid… more
- Molina Healthcare (Omaha, NE)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- State of Massachusetts (Boston, MA)
- …issues or functions. Together the bureaus work to prevent and detect waste , fraud and abuse of public resources in the Commonwealth. Additional information ... is an independent agency charged with preventing and detecting fraud , waste and abuse in the use...when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- Highmark Health (Harrisburg, PA)
- …within the department. + Responsible for completing all necessary field (externally) investigative work for resolution or alleged fraud / waste and abuse cases ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- Office of Inspector General (Atlanta, GA)
- Summary This office works within DOT to detect and prevent waste , fraud and abuse in departmental programs. The OIG reports to the Secretary and Congress and ... will be responsible for planning, directing and conducting complex investigations of suspected fraud , waste , and abuse, and mismanagement in programs of DOT, as… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in ... **Join Our Team: Do Meaningful Work and Improve People's Lives** Our purpose, to...III** will be responsible for investigating allegations of external fraud , waste , and abuse (FWA). The reports… more
- CDPHP (Albany, NY)
- …(4) years of equivalent experience required. + Designation as an Accredited Health Care Fraud Investigator preferred. + Incumbent must meet one of the minimum ... investigating complex insurance cases to detect internal and external fraud and abuse. The Special Investigator will...providers, and members in the identification and remediation of fraud , waste , and abuse. QUALIFICATIONS: + Degree… 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:...Function: Compliance ID**: 29509 **Job Brief** This position will work as a remote employee but must reside in... fraud , waste and / or abuse with… more
- MyFlorida (Miami, FL)
- …Division of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... FINANCIAL CRIME INVESTIGATOR II (PENDING RECLASSIFICATION) - 43061892 Date: May 9, 2024 Location: MIAMI, FL, US, 33128 The State Personnel System is an E-Verify… more
- Environmental Protection Agency (Denver, CO)
- …& investigations of the EPA to promote economy, efficiency, and to prevent and detect fraud , waste and abuse. We strive to provide solutions to problems that ... of Investigations (OI). OI criminal investigators investigate allegations of fraud , waste , abuse and misconduct impacting EPA...portion of the individual's working time over a typical work cycle; and (c) Are assigned on a regular… more
- Manulife (Boston, MA)
- …You will partner with all squads to drive savings associated with fraud , waste & abuse. The Senior LTC Investigator will conduct desktop investigations of ... field investigators + Detects, investigates and prevents allegations of fraud , waste & abuse by, agents/brokers, customers,...+ A dedicated and supportive team environment. + Flexible work policies and work -life balance. + Professional… more
- CVS Health (Springfield, IL)
- …information EDUCATION: *Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay range ... as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone...personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of… more
- CVS Health (Baton Rouge, LA)
- …situation.Education: - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The typical pay range ... as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone...more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of… more
- Commonwealth Care Alliance (Boston, MA)
- …reports. + Knowledge of federal and state laws and regulations pertaining to fraud , waste and abuse. + Desire to work in a collaborative and fast-paced team ... Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr. Associate is an integral part of...Coder Sr. Associate is an integral part of the Fraud , Waste & Abuse (FWA) Special Investigation… more
- Amentum (Richland, WA)
- …Reporting alleged violations of law, regulations, or policy, including incidents of fraud , waste , abuse, misuse, corruption, criminal acts, or mismanagement, ... Title Ethics & Compliance Investigator Position Number 39038 Company WA River Protection...for conducting investigations related to ethics, conflict of interest, fraud , and other issues as assigned. In addition, the… more
- Commerce Bank (Kansas City, MO)
- …culture is about our people, the ones in our communities and the ones that work with us. Here, you'll find opportunities to grow and learn, to connect with others, ... job is to prevent, detect, and investigate financial crimes, waste and abuse against the Bank and the Bank's...stakeholders + Answer calls and emails routed to the investigator and the Duty Line and Resource mailbox +… more
- Headquarters, NASA (Kennedy Space Center, FL)
- …reviews, and investigations of NASA programs and operations to prevent and detect fraud , waste , abuse, and mismanagement. The Office of Investigations (OI) ... investigates allegations of crime, cyber-crime, fraud , waste , abuse, and misconduct having impact...projects, operations, and resources. Responsibilities As a Supervisory Criminal Investigator at the GS-1811-14 grade level, some of your… more
- Point32Health (Canton, MA)
- …team member of the SIU, responsible for leading complex provider investigations related to fraud , waste and abuse, and developing action plans to address the ... navigating health and wellbeing easier. We enjoy the important work we do every day in service to our...monitor provider activity post-investigation + Identifying root causes of fraud , waste and abuse and recommending internal… more
