- Franklin Energy (Milwaukee, WI)
- …of criminal offenses such as vehicle vandalism and break-ins and staged-accident fraud , defense of legal claims , driver exoneration, and driver training ... and mirrors our diverse partnerships, clients and communities we serve. Position SummaryThe Senior Software Engineer will work on the within the Technology Group to… more
- Option Care Health (Bannockburn, IL)
- …action policies and procedures.Reporting to the VP, Compliance & Privacy Operations , this individual will also assist Compliance leadership with:* Developing and ... all applicable laws, regulations, and internal policies related to healthcare operations .Job Description: Job Responsibilities (listed in order of importance and/or… more
- Franklin Energy (Meridian, MI)
- …of criminal offenses such as vehicle vandalism and break-ins and staged-accident fraud , defense of legal claims , driver exoneration, and driver training ... for providing expert system and program engineering support to Franklin Energy operations teams, AM Conservation delivery teams, and utility clients. This engineer… more
- M&T Bank (Atlanta, GA)
- …clients. Work with these teams to improve internal processes associated with fraud events, including investigations, claims , and coordination of activities. + ... a minimum of 10 years' proven marketing, product management, financial, operations and/or project management experience. *M&T's Fraud Mitigation Program… more
- Bank of America (Richmond, VA)
- …metrics to identify root causes ▪ Basic understanding of 1st and 3rd party fraud ( claims to charge-off timing, chargeback recovery rights, etc.) ▪ Proven strong ... Cons Prod Strat Analyst III- Digital Fraud Strategies Charlotte, North Carolina;Belfast, Maine; Plano, Texas;...the production of product performance reports and updates for senior management + Analyze complex data to provide insights… more
- USAA (Plano, TX)
- …so special! As a dedicated The Business Applications Lead for Bank Fraud Claims , Disputes, and Investigations is a senior role responsible for overseeing the ... development, implementation, and optimization of business applications designed to manage fraud claims , dispute resolutions, and investigative processes within a… more
- Axis (Red Bank, NJ)
- …in the selection process. AXIS is seeking a **_Head of Quality Assurance & Compliance, Claims Shared Services_** to join our Shared Services Claims team. As a ... the ability to implement, develop and lead a successful Claims Quality Assurance and Compliance program for Axis ...to internal stakeholders + Assisting with maintenance of SIU, Fraud reporting and other Compliance reporting and procedures as… more
- The Cigna Group (Denver, CO)
- … claims processing capabilities, Evernorth Accountable Care is seeking an experienced Claim Operations senior leader to build a high performing team of claim ... analysts and operations personnel to support the business in ongoing claim operations . **Essential Functions** The Senior Manager of Claim Operations … more
- State of Massachusetts (Boston, MA)
- …* Reviewing complaints and referrals, including assisting with the day-to-day operations of Office's fraud hotline. * Investigating and documenting ... is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public...bureaus: Specialty & General Government, Legal & Compliance, and Operations , Training & Publications. Each bureau contains divisions that… more
- American Express (New York, NY)
- …of Whistleblower claims , Significant Ethics Violations, and certain instances of Fraud to the Audit and Compliance Committee of the Board of Directors. We ... compliance, technology, operational risk, financial accounting, data analytics, and banking operations . Most IAG team members hold at least one professional… more
- Bausch Health (Bridgewater, NJ)
- …of improving people's lives with our health care products. Reporting to the Senior Director, Finance (Revenue & GTN Accounting), the Senior Manager, Finance ... Medicare Part D contracts and will oversee the daily operations of the contract management function. This individual will...**Areas of responsibility -** + Review and approve rebate claims data received for managed care contracts, Medicare Part… more
- CVS Health (Austin, TX)
- … claims billed and educating pharmacies on the findings. You will also analyze claims for fraud , waste, and abuse trends and report your findings to the ... manner - Knowledge of CVS Health (or other PBM) claims processing - Knowledge of retail pharmacy operations... claims processing - Knowledge of retail pharmacy operations including reading prescriptions and drug knowledge - Excellent… more
- Raymond James Financial, Inc. (Pittsburgh, PA)
- …to corporate, institutional, and high-net-worth (HNW) clients.** **Job Summary:** The Senior Wire Operations Associate will deliver high quality customer ... of financial transactions in a fast paced, time sensitive operations environment. The Senior Wire Operations...status queues. The incumbent will also be responsible for fraud monitoring and investigation, working closely with internal and… more
- Abbott (Santa Clara, CA)
- …to health care professionals and reimbursement by government programs, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA regulation ... identify and resolve complex legal issues to support the operations of a global leader in the research, development,...minimal supervision and understand which issues to elevate to senior management and appropriate timing for doing so. +… more
- BD (Becton, Dickinson and Company) (San Diego, CA)
- …health care professionals and reimbursement by government programs, including, for example, fraud and abuse (Anti-Kickback Statute, False Claims Act), FDA ... and maintaining valuation models and transactional, diligence and integration processes. The Senior Counsel, Commercial Business Units, will be a member of the… more
- Bausch Health (Seattle, WA)
- …global regions and with functional departments such as R&D, regulatory, quality, sales, operations & downstream marketing is a must for success in this role. ... competitive landscape, integrate business needs into the product and ensure desired claims are in marketing plan. + Develop comprehensive marketing & launch plans… more
- Leonardo DRS, Inc. (Beavercreek, OH)
- …of conduct to include: conflicts of interests; improper practices; liability and fraud + Understand contract design and structure to include: FFP; CPIF; CPFF; ... IT utilization through electronic commerce and ERP/Oracle implementation + Provide claims and litigation support involving ASBCA and USCFC + General business… more
- Leonardo DRS, Inc. (Fitchburg, MA)
- …of conduct to include: conflicts of interests; improper practices; liability and fraud + Understand contract design and structure to include: FFP; CPIF; CPFF; ... Strong Presentation Skills with ability to adapt to multiple audiences + Provide claims and litigation support involving ASBCA and USCFC + General business … more
- EFI Global (Orlando, FL)
- …analysis and engineering projects for clients.** **Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers ... decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global… more
- Boehringer Ingelheim (Ridgefield, CT)
- …Quality and Integrity by implementing plausibility checks, anomaly detection, and fraud detection methods in data collection systems. Supports the clinical research ... Project/Trial level technical specifications for new substances, indications or marketing claims .As an employee of Boehringer Ingelheim, you will actively contribute… more
