- Mount Sinai Hospital (New York, NY)
- …or HS Diploma/GED plus two years of related experience. 3 years of health claims billing experience; prefer experience working with CPT and ICD9 coding and CCI edits ... of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's… more
- Elevance Health (Norfolk, VA)
- **Clinical Fraud Investigator Senior ** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... and adaptable workplace. Alternate locations may be considered. The **Clinical Fraud Investigator Senior ** is responsible for identifying issues and/or entities… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit (SIU) Senior Investigator is to assist in the reduction and recuperation of ... effective and result in an overall achievement of unit goals. + Senior Investigator will develop documentation that supports conclusions, recommendations, and… more
- City of New York (New York, NY)
- …Collections (C&C) is recruiting (1) one Fraud Investigator II to function as a Senior Investigator , who will: - Send letters to Clients to require a response ... Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE The DSS Accountability Office (DSS-AO) is responsible for protecting the… more
- Dycom (West Palm Beach, FL)
- …insurance, and much more! **What you'll do as a Senior Investigator ** + Conduct investigations into claims of potential harassment, discrimination, workplace ... **Discover a more connected Senior Investigator , Employee Relations (bilingual)** **career** At Dycom Industries, Inc as a Senior Investigator , you'll be… more
- CVS Health (Carson City, NV)
- …And we do it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- New York Power Authority (Buffalo, NY)
- Senior EEO Investigator Location: White Plains, USBuffalo, USMarcy, US **Summary** The Senior Equal Employment Opportunity (EEO) Investigator is ... harassment, and other EEO-related issues within the organization. The Investigator will also assist in facilitating reasonable accommodations for employees… more
- City of New York (New York, NY)
- …in their agreement to repay. Claims &Collection is recruiting for (4) four Fraud Investigator II to function as a Senior Fraud Investigator , who will: - ... Job Description Claims and Collections pursues monetary recoveries owed to...their cases and obtain additional information (if necessary) FRAUD INVESTIGATOR - 31113 Qualifications 1. A four-year high school… more
- SGI Global, LLC (Mobile, AL)
- …USA | Ability to obtain clearance | Full Time SGI Global is seeking a Senior Civil Investigator to support the Affirmative Civil Enforcement (ACE) program at the ... taxpayer dollars and uphold the integrity of federally funded programs. The Investigator will work closely with Assistant United States Attorneys (AUSAs) and agency… more
- MyFlorida (Orlando, FL)
- SENIOR CHILD PROTECTIVE INVESTIGATOR - 60070936 Date: Jul 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 857107 Agency: Children and Families Working Title: SENIOR CHILD PROTECTIVE INVESTIGATOR - 60070936 Pay Plan: Career… more
- CVS Health (Hartford, CT)
- …heart, each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
- EFI Global (Detroit, MI)
- …buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims . + Ensures that assigned cases are investigated and...ethical manner. + May provide investigative guidance to Fire Investigator team members. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- EFI Global (Los Angeles, CA)
- …Click here to learn more about EFI Global. Seeking a certified fire investigator in the greater Los Angeles area. Must hold IAAI-CFI certification. **PRIMARY ... buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
- Allied Solutions (Plano, TX)
- …all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and lender ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- Elevance Health (Indianapolis, IN)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... ** Investigator II** **Supporting the Payment Integrity line of business**...of proprietary data and claim systems for review of facility,… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6481) Job Brief Assists the Incident Management Investigator with conducting investigations into situations, which may violate… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... recommendations. 5. In conjunction with the assigned Incident Management Investigator Specialist, prepares investigative reports and forwards completed reports to… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Type of Position Per Diem Search Location(s) Manhattan, NY Apply Now ... investigations. 6. In conjunction with the assigned Incident Management Investigator Specialist, prepares investigative reports and forwards completed reports to… more
- City of New York (New York, NY)
- …Safety seeks to hire an Environmental, Health and Safety Incident/Workplace Violence Investigator located in Flushing, New York. Under general direction, but with ... selected candidate will be responsible for the following: 1) As a lead Investigator or part of an investigation team conduct investigations into incidents such as… more
- Mount Sinai Health System (New York, NY)
- …Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible ... to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The… more
