- Elevance Health (Seattle, WA)
- ** Investigator Senior ** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per week, ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior ** is responsible for the independent identification,… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Insurance Fund, State Title Investigator 1, Senior Investigative Officer Occupational Category Other Professional Careers Salary Grade NS ... and mitigate fraud. DCI is comprised of four separate teams: Claims Fraud, Provider Fraud, Policyholder Fraud and Data Analytics.Responsibilities include, but… more
- Kanaan Communications, LLC (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, workplace ... Discover a more connected Senior Investigator , Employee Relations (bilingual) career At Dycom Industries, Inc as a Senior Investigator , you'll be… 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
- City of New York (New York, NY)
- …pre-tax programs such as Deferred Compensation, IRA, and a flexible spending account. SENIOR RACKETS INVESTIGATOR - 30831 Qualifications 1. Graduation from high ... of this mission, the BXDA seeks experienced and enthusiastic, well-qualified investigator to collaborate with experienced attorneys in the Conviction Integrity… 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
- Michigan State University (East Lansing, MI)
- …and providing status reports to community partners. Collaborating with the Director, Senior Investigator , advocates and advisors to ensure appropriate resources ... Position Summary The Civil Rights Investigator position is located within the Investigation, Support, and Resolution Department and is responsible for numerous… more
- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for overseeing the ... in Virgina to enhance the program's transparency and accountability. The Senior Fraud and Waste Professional also conducts investigations into allegations of… 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 (Houston, TX)
- …paid on fraudulent claims . **How you will make your impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and ... ** Investigator II** **Location:** _Hybrid1_ : This role requires associates...use of proprietary data and claim systems for review of facility, professional… 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
- 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
- Weill Cornell Medical College (New York, NY)
- Title: HR Investigator Location: Midtown Org Unit: Office of Institutional Equity Work Days: Weekly Hours: 35.00 Exemption Status: Exempt Salary Range: $106,500.00 - ... violations of WCM HR policies involving academic and non-academic staff. The Investigator performs comprehensive investigations into a wide range of HR issues,… 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
- 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
- Ally (Topeka, KS)
- …appropriate channels to ensure reasonable resolution. The Auto Fraud Investigator is responsible for conducting sophisticated investigations and in-depth research ... ensuring applicable regulatory compliance, and preparing investigative reports for both senior leadership and FinCEN. * Apply good judgment and knowledge of… more
- FlexStaff (New York, NY)
- **Req Number** 158977 FlexStaff is seeking an Incident Management Investigator to join our client's team, a leading organization that provides housing, services and ... with Administrator of Investigations, Administrator of Incident Management and/or Senior Vice President of Quality Assurance and Quality Improvement contacts… more
- Mount Sinai Health System (New York, NY)
- …Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Hospital Billing) Analyst who will primarily be responsible for ... 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
- Mount Sinai Health System (New York, NY)
- **Job Description** Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and ... CPT and ICD (coding and CCI edits). + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted...payer and provider representatives to negotiate higher rates for claim payments. 6. Responds to patient and third party… more