- Elevance Health (Richmond, VA)
- Anticipated End Date: 2025-07-31 Position Title: Clinical Fraud Investigator II - Registered Nurse and CPC - Carelon Payment Integrity SIU Job Description: Clinical ... Fraud Investigator II - Registered Nurse and CPC - Calrelon...Performs in-depth investigations on identified providers as warranted. Examines claims for compliance with relevant billing and processing guidelines… more
- Greenlife Healthcare Staffing (New York, NY)
- Registered Nurse - Nursing Home Surveyor / Complaint Investigator Job ID: #6045 Location: New York, NY Employment Type: Contract / Travel Hourly Rate: $45/hour + ... Nurse (RN) to serve as a Nursing Home Surveyor/Complaint Investigator in New York, NY . In this critical...Experience : At least 2 years in utilization review, claims , medical review, fraud investigation , or monitoring ;… more
- Hillsborough Community College (Tampa, FL)
- …which the instructor is required to hold a specified level of professional certification and/or a Bachelor's degree. Examples: Financial Planning taught by a CFP, ... Real Estate, Insurance and Construction Licensing, Information Technology, Private Investigator . Closing Date: Open until filled Hillsborough Community College is an… more
- County of Los Angeles, CA (Los Angeles, CA)
- …quality assurance inspectors when Federal Aviation Administration (FAA) certification is requiredby recommending procedures and inspecting/testing equipment in ... to view correspondence. Los Angeles County will not consider claims of not viewing or receiving notification to be...information will only be disclosed to an assigned background investigator if he/she is deemed suitable for the job… more
- MyFlorida (Orlando, FL)
- …protective investigative related experience; and + Current Florida Child Protective Investigator certification Preferences: + Bachelor's degree in social work, ... SENIOR CHILD PROTECTIVE INVESTIGATOR - 60070936 Date: Jul 25, 2025 The...ORDER TO BE CONSIDERED. + All Investigators must maintain certification as a Child Welfare Professional as a condition… more
- EFI Global (Detroit, MI)
- …degree from an accredited college or university preferred. IAAI Certified Fire Investigator (IAAI-CFI) certification or Certified Fire & Explosion ... Investigator (CFEI) certification . **Experience** Five (5) years of fire investigation experience or equivalent combination of education and experience required.… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- …REQUIREMENTS: 1. Minimum BA/BS in related Human Services Field. 2. Must be a certified investigator or be able to pass the certification course within 60 days of ... Incident Management Investigator Type of Position Full time Search Location(s)...code of business conduct, the NYS and federal false claims acts, whistleblower protections and mandatory reporting. Completes corporate… more
- State of Colorado (CO)
- Financial Investigator (Criminal Investigator IV) - Division of Gaming Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5010422) Apply ... Financial Investigator (Criminal Investigator IV) - Division of...entity to identify all parties who may have a claim to the company's assets, including those whose ownership… more
- Texas A&M University System (Texarkana, TX)
- …and work cooperatively with others. + Ability to obtain and maintain investigator certification + Knowledge of Microsoft Office applications, including Word, ... and FMLA. Responds to unemployment insurance and worker's compensation claims . + Implements the performance improvement process by diagnosing...or related field + PHR/SPHR, or SHRM-CP or SCP certification + Knowledge of employment and labor laws +… more
- State of Arkansas (Little Rock, AR)
- …*Presenting evidence * Interviewing witnesses Job Summary: Review Incident and Accident claims as assigned by the lead investigator Perform a thorough ... Investigator II (IIV03P) Date: Jul 25, 2025 Req...procedures to program participants Attend and present information on claims investigated to DPSQA's I&A Committee Represent DHS as… more
- Elevance Health (Metairie, LA)
- …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 Senior - Carelon Payment Integrity SIU** **Location:** Must be...of proprietary data and claim systems for review of facility, professional… more
- Molina Healthcare (St. Petersburg, FL)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- Elevance Health (Atlanta, GA)
- …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 - Payment Integrity SIU** **Location:** This role requires...of proprietary data and claim systems for review of facility, professional… more
- EFI Global (Los Angeles, CA)
- …anywhere. Click here to learn more about EFI Global. Seeking a certified fire investigator in the greater Los Angeles area. Must hold IAAI-CFI certification . ... buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
- San Jose State University (San Jose, CA)
- … Investigator Apply now (https://secure.dc4.pageuppeople.com/apply/873/gateway/default.aspx?c=apply&lJobID=544207&lJobSourceTypeID=837&sLanguage=en-us) Job no: 544207 ... MPP, At-Will, Compliance/Legal, Full Time Job Summary The Civil Rights Investigator is responsible for conducting investigations pertaining to protected status… 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 ... adaptable workplace. Alternate locations may be considered. The **Clinical Fraud Investigator Senior** is responsible for identifying issues and/or entities that may… more
- Dycom (West Palm Beach, FL)
- …pet insurance, and much more! **What you'll do as a Senior Investigator ** + Conduct investigations into claims of potential harassment, discrimination, ... **Discover a more connected Senior Investigator , Employee Relations (bilingual)** **career** At Dycom Industries,...Workspace software + PHR/SPHR or SHRM CP or SCP certification + Strong interpersonal and conflict resolution skills +… more
- EFI Global (Phoenix, AZ)
- …and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of ... the assignment.** **Determines the origin and cause of the loss/ claim under investigation and identifies any potential third-party responsibility for subrogation… more
- EFI Global (Syracuse, NY)
- …and RESPONSIBILITIES** **Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of ... the assignment.** **Determines the origin and cause of the loss/ claim under investigation and identifies any potential third-party responsibility for subrogation… more
- CVS Health (Carson City, NV)
- …it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
Related Job Searches:
Certification,
Claim,
Claim Investigator,
Investigator,
Investigator Certification