- Prime Therapeutics (Columbus, OH)
- …health care business model and processes, preferably in behavioral health, radiology or pharmacy . + 3+ years' fraud investigations /claims experience. + ... and policy interpretation. **Work Experience** Work Experience - Required: Claims, Fraud Investigations Work Experience - Preferred: **Education** Education -… more
- CVS Health (Austin, TX)
- …+ Proven track record in recognizing and resolving large scale ecommerce and online fraud . (.com) + Proven ability to resolve investigations and deploy tactics ... convenient and affordable. Position Summary The purpose of the Senior Manager, Organized Retail Crime is to develop and...from losses due to large-scale organized external theft and fraud . This includes managing up to $75 Million dollars… more
- Elevance Health (Columbus, OH)
- ** Senior Investigator (Investigator Sr )** _Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Senior Investigator** is responsible for the independent identification, investigation… more
- Elevance Health (Columbus, OH)
- Job Description ** Senior Investigator** **Schedule:** 1-2 days per week in the office (Hybrid 1) **Location:** This position will work a hybrid model (remote and ... miles of one of our Elevance Health PulsePoint locations. The ** Senior ** **Investigator** position is responsible for the independent identification, investigation… more
- Elevance Health (Columbus, OH)
- **Investigator Senior ** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... recover, eliminate and prevent unnecessary medical-expense spending. The **Investigator Senior ** is responsible for the independent identification, investigation and… more
- Elevance Health (Norfolk, VA)
- **Investigator Senior ** **Location** : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations. The **INVESTIGATOR SENIOR ** is responsible for the independent identification, investigation and development of complex cases… more
- Elevance Health (West Des Moines, IA)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... data and claim systems for review of facility, professional and pharmacy claims. + Responsible for identifying and developing enterprise-wide specific healthcare… more
- Elevance Health (Columbus, GA)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... data and claim systems for review of facility, professional and pharmacy claims. + Responsible for identifying and developing enterprise-wide specific healthcare… more
- Insight Global (Deerfield, IL)
- …individual will assist with Financial, Operational, and compliance audits or investigations - under general supervision of a more experienced auditor. Reviews and ... improvements in internal control. Very team oriented, two staff, senior , manager then a director (for each audit project)...identify risks in a given process. May participate in investigations being performed by the Internal Audit function. Based… more