- Allied Solutions (Plano, TX)
- …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** **Position Summary:** The FWA Investigator Coder Sr . Associate is an integral part of the Fraud, Waste & Abuse (FWA) ... with providers, and other CCA departments related to review processes and results. Sr Associate, FWA Investigator Coder utilizes claim analysis, document review,… more
- National General Insurance Company (TX)
- National General is seeking an SIU Field Investigator for the San Antonio, or Austin, TX area. The ideal candidate will have previous experience as an SIU ... Investigator within an Insurance carrier. JOB SUMMARYThis job is...responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation… more
- EFI Global (Edina, MN)
- …requirements for consideration.** **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 reported back to the requesting party in adherence to best practices.… 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...and one year of satisfactory, full-time experience as an investigator as described in "1" above; or 3. A… more
- Johns Hopkins University (Baltimore, MD)
- …The platform houses Centers for Medicare & Medicaid (CMS) health insurance claims data and is integrating next-generation data linkages while expanding access across ... health system. The successful candidate will serve as a co- investigator on health economics projects led by Drs. Melinda...code library for data processing and analysis across healthcare claims data. + Provide research support on topics including… more
- CVS Health (Baton Rouge, LA)
- …to make health care more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of ... intricate healthcare fraud schemes. - Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business- Researches and prepares cases… more
- CVS Health (Springfield, IL)
- …make health care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of ... or intricate healthcare fraud schemes * Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business * Researches and prepares… more
- UNC Health Care (Morrisville, NC)
- …Develop appropriate employee relations plans and interventions. Effectively investigate claims /charges, review all pertinent facts and information without expanding ... reporting, Employee Management Services Mediation, Arbitration, Grievance monitoring, Employee Recognition Program. Technical assistance Provide support analyst functions on… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: The Equal Employment Opportunity and Title IX Investigator (EEO/Title IX Investigator ) serves as part of a team investigating and resolving ... the University's legal obligations to address discrimination and harassment claims and sexual misconduct. Document findings as to the...Officer and Associate VP for Equity & Inclusion and Sr . Associate Dean for Equity & Inclusion SMD, the… more
- CVS Health (Richmond, VA)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... the recovery of company and customer money lost as a result of fraud matters. - Provides input regarding controls for monitoring fraud related issues within the business units. - Delivers educational programs designed to promote deterrence and detection of… more
- Immigration and Customs Enforcement (IN)
- …Office of the Chief of Staff. The incumbent serves as an entry-level investigator in the IHSC Investigations Unit (IIU). This is a non-supervisory position. This ... not eligible for this position. Responsibilities DUTIES AND RESPONSIBILITIES: As an Investigator , the incumbent will perform, but not limited to, the following… more
- American Electric Power (Corpus Christi, TX)
- …posting end date. **Job Summary** This single vacancy is posted in a range of Claims Adjuster, Senior to Claims Adjuster, Principal. Please note that ... Austin or other locations in the State of Texas) CLAIMS ADJUSTER, SENIOR (SALARY GRADE 6) ...to the litigation process. + Conduct Public Liability Accident Investigator Training sessions. + Train and mentor others within… more
- Elevance Health (St. Louis, MO)
- ** Investigator II** **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 II** is responsible for the identification, investigation and...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… 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
- Johns Hopkins University (Baltimore, MD)
- …faculty, staff, and students on discrimination, harassment, sexual misconduct and retaliation claims . + Receive complaints from various members of the JHU community ... and educational programs to various University community members, including senior management on discrimination, harassment, sexual misconduct and retaliation. +… more
- Boehringer Ingelheim (St. Joseph, MO)
- …programs reflect Boehringer Ingelheim's high regard for our employees. The Senior Clinical Research Associate (SCRA) conducts in-house and external monitoring to ... of study protocols, raw data, and reports to support registrations and other claims related to veterinary products. The SCRA performs these duties for on-site and… more
- The Mount Sinai Health System (New York, NY)
- Senior Clinical Risk Manager The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote patient safety, quality of care, ... loss to protect the assets of the facility. The Senior Risk Manager supports the Risk Management staff on...with the HRA/TDC on-site Professional Liability Investigators: reporting potential claims as well as cases of concern by preparation… more
- Stryker (District Of Columbia, DC)
- …More information is available at www.stryker.com We are currently seeking a ** Senior Staff Regulatory Affairs Specialist** to join our **Spine Division** based ... complete and meets regulations and expectations. **What you will do** As the Senior Staff Regulatory Affairs Specialist, you will work to maintain medical devices on… more
- Point32Health (Boston, MA)
- …meet the investigator 's needs + Lead analysis of large medical claims and/or electronic health record data in support of surveillance or observational research ... Harvard Medical School's Department of Population Medicine (www.populationmedicine.org) as a Senior Research Analyst. TIDE is the home of several large, complex,… more