- Elevance Health (Lake Mary, FL)
- **Pharmacy Investigator Senior ** **Hybrid** : This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... accommodation is granted as required by law. The **Pharmacy Investigator Senior ** is responsible for the independent...claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review,… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or ... fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...+ The ability to understand and analyze health care claims and coding + Ability to travel up to… more
- City of New York (New York, NY)
- …arrears as stipulated in their agreement to repay. C&C is recruiting for (1) one Fraud Investigator II to function as a Senior Fraud Investigator , who will: ... Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The DSS Accountability Office… more
- Galileo Financial Technologies, LLC (Jacksonville, FL)
- …. The Role We are seeking a talented and self-motivated Senior Fraud Investigator to support our Fraud Investigations team. ... ensure compliance with regulatory institutions and Galileo policies and procedures. The Senior Fraud Investigator is responsible for conducting holistic reviews… more
- MyFlorida (Orlando, FL)
- SENIOR CHILD PROTECTIVE INVESTIGATOR - 60022401 Date: Jan 7, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 867782 Agency: Children and Families Working Title: SENIOR CHILD PROTECTIVE INVESTIGATOR - 60022401 Pay Plan: Career… more
- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will… more
- Manulife (FL)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... and trains more junior investigators on long term care claim cases and processes + Ability to travel on...short notice and responds to urgent long term care claim investigations + Maintains knowledge of sophisticated investigative techniques,… more
- EFI Global (Los Angeles, CA)
- …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 reported back to the requesting party in adherence to best practices.… 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 reported back to the requesting party in adherence to best practices.… 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 (Columbus, OH)
- …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** **Locations:** Indianapolis, IN, Nashville, TN, Columbus, OH...of proprietary data and claim systems for review of facility,… 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
- Otsuka America Pharmaceutical Inc. (Waltham, MA)
- **Job Summary** The Senior Director will serve as the Translational Medicine CNS Therapeutic Area Head, reporting to the VP, Translational Medicine and Early ... Clinical Development within OPDC's Early Development Organization (EDO). The Senior Director Translational Medicine will oversee a small team of CNS Translational… more
- MyFlorida (Tallahassee, FL)
- SENIOR ASSISTANT ATTORNEY GENERAL-DLA - 41000379 Date: Jan 9, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... 866755 Agency: Office of the Attorney General Working Title: SENIOR ASSISTANT ATTORNEY GENERAL-DLA - 41000379 Pay Plan: SES...cases under state and federal antitrust laws, Florida False Claims Act, Florida securities law, Civil Racketeering and as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Senior Director, Patient Financial Services (Backend) Corporate East 42nd Street-Full-Time Days** The Senior Director Patient Financial ... and Accounts Receivable performance across the medical center. The Senior Director will report to the Vice President Patient...workflows align with revenue cycle best practices to reduce claim denials, improve cash collections and enhance clean … more
- Mount Sinai Health System (New York, NY)
- …Opportunity for advancement within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations ... + Opportunity for mentorship from senior MSHP leaders + Opportunity to be part of...preferred. + Firm understanding of Facility, Professional and Pharmacy claim reimbursement preferred. + Oral presentation experience, especially with… more
- Otsuka America Pharmaceutical Inc. (Olympia, WA)
- **Job Summary** The Senior Manager of Global Quality Management (GQM) supports the execution of clinical quality activities to ensure compliance with Good Clinical ... of the annual audit plan using risk-based approaches. + Coordinate and support investigator site, vendor, and internal process audits. + Track audit findings and… more
- University of Southern California (Los Angeles, CA)
- …excellence, and private and public sector engagement, is looking for a Senior SAS Research Programmer to provide programming support on research projects examining ... health behavior research and related health policy topics. The Senior SAS Research Programmer will serve as lead programmer and technical specialist on research… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR ELECTRONICS COMMUNICATIONS EQUIPMENT INSTALLER Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5154984) Apply SENIOR ELECTRONICS ... please view the classification specification: Senior Electronics Communication Equipment Installer… more
- Mount Sinai Health System (New York, NY)
- …Opportunity for advancement within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations ... + Opportunity for mentorship from senior MSHP leaders + Opportunity to be part of...In-depth knowledge of healthcare revenue cycle processes, including billing, claims management, and payment reconciliation. + Familiarity with **Stratajazz**… more