- The Hartford (Los Angeles, CA)
- …mission of the Special Investigations Unit (SIU) is to contribute to claims accuracy by building fraud awareness and investigating questionable claims . ... and ears" of the SIU on the ground, performing investigations to provide information to claims handlers,...of investigative techniques and the laws pertaining to insurance claims and mandated fraud reporting as well… more
- Ankura (Washington, DC)
- …to Life Sciences clients and external counsel through compliance, disputes, investigations and advisory services. The position has tremendous growth potential with ... be working with practice leadership to provide exemplary compliance, disputes, investigations and litigation support (eg, expert witness) services across the Life… more
- Ford Motor Company (Fort Worth, TX)
- …using Mitchell Connect estimating system to establish cost of repairs. + Subrogation investigations , salvage disposal, and fraud investigations + Loss ... world. **In this position ** + The APD Auto Physical Damage Catastrophe Claims Adjuster/Field Service Manager is a field-based position representing Ford Motor… more
- Eastern Bank (Lynn, MA)
- …is responsible for the initiation, investigation and resolution of diverse and complex investigations both internal and external, to determine fraud exposure to ... of incoming fraud referrals to the CSI (Corporate Security & Investigations ) Team. Tracking, analyzing, reporting and keeping accurate and detailed records in… more
- Walmart (Douglas, GA)
- …with specific types of tools used for theft prevention. Conducts investigations . Recognizes and investigates security breaches, thefts, shortages (loss), and ... management. Responds to inquiries by regulatory authorities. Consults on complex claims and settlements. Designs preventative claims management processes (for… more
- Walmart (Chino, CA)
- …with specific types of tools used for theft prevention. Conducts investigations . Recognizes and investigates security breaches, thefts, shortages (loss), and ... management. Responds to inquiries by regulatory authorities. Consults on complex claims and settlements. Designs preventative claims management processes (for… more
- CVS Health (Columbus, OH)
- …compassionate. And we do it all with heart, each and every day. The Special Investigations Unit is seeking a Manager to lead our team of Certified Professional ... Coders (CPC). The Manager is responsible for overseeing and managing coding reviews...claims processing, and regulatory requirements related to healthcare fraud . Proficient in researching information and identifying information resources… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- The Manager will report to the Associate Director, Transparency & Aggregate Spend, GRC and will oversee and ensure OAPI and OPDC compliance with state financial ... reporting. + Support healthcare law auditing and monitoring and investigations activities as needed + Provide operational support to...Ability to meet deadlines with minimal supervision, as a manager as well as a team member + Proven… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- Manager , Product Quality Complaints develops, implements, and maintains complaint management system in a manner that is compliant with regulatory requirements and ... Parts 210, 211, 820, 10.115(b specifically those applicable to complaint handling, investigations , and documentation + Proven experience as a Complaints Manager … more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- **Job Summary** **The Senior Manager ,** **GPV Compliance & Business Management will support the** **leads of Global PV** **Audit & Inspection readiness** **(AIR)** ... limited to the planning and** **conducting** **readiness activities/training.** **As the** **Sr. Manager for audits and inspection** **, support the GPV Audit &… more
- Centene Corporation (Harrisburg, PA)
- …may substitute for the Bachelors Degree . 5+ years of management experience Investigations and healthcare fraud -related investigations with audit and risk ... acts as a subject matter expert in the field of Compliance and/or Special Investigations Unit (SIU) investigations . Provides direction and guidance to staff who… more
- Lundbeck (Deerfield, IL)
- Senior Manager Compliance Programs - Remote Opportunity Requisition ID: 6332 Location: Deerfield, IL, US Do you want to join a team where the mission is meaningful, ... and (2) developing risk assessment protocols for ongoing review. + ** Investigations :** Assist with internal compliance investigations ensuring legal compliance… more
- Staples (London, OH)
- …and programs in Supply Chain locations related to inventory loss, theft, and fraud . + Ensures appropriate internal risk controls are in place through the application ... of programs including data analysis, audits, training, and investigations . + Manages the Asset Protection Associate teams responsible for front line security in FCs… more
- LifePoint Health (Richlands, VA)
- …ever-changing legislation and safety regulations. Is a liaison to the Risk Manager /Coordinator, facilities legal team and out-side agencies to mitigate and manage ... and the risk management, mediates patient and employee complaints and investigations * Coordinates Quarterly Rural Health Audits and compliance for accreditation.… more
- Robert Half Finance & Accounting (Horsham, PA)
- …already solid foundation. Responsibilities: + Oversee and direct forensic accounting investigations involving fraud detection, financial disputes, and asset ... Description Robert Half is seeking an experienced and driven professional Audit Manager to lead and grow our client's Forensics, Litigation, and Valuation practice.… more
- Travelers Insurance Company (Lake Oswego, OR)
- …. Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where ... all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud .Proactively manage inventory with documented… more
- Travelers Insurance Company (Diamond Bar, CA)
- …. Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where ... all offset opportunities, including apportionment, contribution and subrogation. + Evaluate claims for potential fraud . Proactively manage inventory with… more
- Elevance Health (South Portland, ME)
- …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- Elevance Health (Hanover, MD)
- …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- Elevance Health (Atlanta, GA)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... claims . **How you will make an impact:** + Claim...+ Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health… more
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