- Dexian - DISYS (Baltimore, MD)
- …or investigations related area such as Certified Fraud Examiner (CFE),Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional ... unit goals. Investigator researches and analyzes claims data using company anti- fraud software, Excel, and other tools to proactively identify new potential… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …(RN), Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of ... and regulatory agencies. + May attend webinars and conferences like BCBSA, National Health Care Anti- Fraud Association (NHCAA), and Association of Certified … more
- CDPHP (Albany, NY)
- …of employment. + Certified Outpatient Coder (COC) Certification is preferred. + Accredited Health Care Fraud Investigator (AHFI(R)) accreditation to be ... in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to… more
- State of Montana (Helena, MT)
- …by a Voluntary Employee Beneficiary Association (VEBA) *JOB DUTIES:* As a Fraud Investigator , you will: * Planning, coordinating, and conducting investigations ... accommodation with the application process, please contact the HR office. **Title:** * Fraud Investigator * **Location:** *Helena* **Requisition ID:** *24141037* more
- Elevance Health (Las Vegas, NV)
- …a check, or ask you for payment as part of consideration for employment. **Clinical Fraud Investigator II** + Job Family: FRD > Investigation + Type: Full time ... some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of...1-2 days in office per week The **Clinical Fraid Investigator II** is responsible for identifying issues and/or entities… more
- State of Georgia (Fulton County, GA)
- Investigator - Medicaid Fraud Division Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/37043/other-jobs-matching/location-only) Hot ... through this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care … more
- MUFG (Tempe, AZ)
- …details. Reporting to the Senior Fraud Prevention Manager (Vice President) of Fraud Operations. The Investigator will complete fraud investigations to ... experience and general level of supervision required by the Senior Fraud Prevention Manager. **Major Responsibilities:** + Analyze account transactions to determine… more
- SGI Global, LLC (Raleigh, NC)
- SGI Global is seeking a Civil Investigator (Healthcare Fraud and Opioid Matters) to support Affirmative Civil Enforcement ("ACE") Program for the United States ... Office for the Eastern District of North Carolina. The investigator will be assigned cases and matters that vary...actions within the jurisdiction of the USAO-EDNC involving opioid-related health care fraud violations. + Working with… more
- State of Michigan (MI)
- Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland, Wayne Co Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/3739587) Apply ... Regulation Agent 9-P11 ( Fraud Investigator ) - OIG - Macomb, Oakland,...Full Time Remote Employment Flexible/Hybrid Job Number 4301-22-OIG-039-FILL Department Health and Human Services - Central Office Opening Date… more
- State of Massachusetts (Framingham, MA)
- …of Transitional Assistance (DTA) is seeking qualified applicants for the position of* Fraud Investigator *. The selected candidate will be responsible for ... **Compliance and Certification* **Organization:** **Department of Transitional Assistance* **Title:** * Fraud Investigator - Fitchburg/Framingham* **Location:** *Massachusetts-Framingham-300 Howard Street*… more
- Gilead Sciences, Inc. (Foster City, CA)
- …across the globe. We continue to fight against the world's biggest health challenges, and our mission requires collaboration, determination and a relentless drive ... their economic status. **About the Role** The global pharmaceutical crime and healthcare fraud market is currently estimated at $400 billion annually. It is too… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who ... investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- US Bank (Fargo, ND)
- …That's why our benefits are designed to help you and your family boost your health , protect your financial security and give you peace of mind. Our benefits include ... the following (some may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional term life insurance + Short-term and long-term disability + Pregnancy disability and parental leave + 401(k) and employer-funded… more
- Ventura County (Ventura, CA)
- District Attorney Investigator I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4165939) Apply District Attorney Investigator I/II ... for prosecution. The Bureau is staffed with a chief investigator , a deputy chief investigator , 3 commanders,...wide range of investigations from homicide to complex white-collar fraud schemes. The Bureau of Investigation has three divisions:… more
- MyFlorida (Miami, FL)
- FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004823 Date: Apr 25, 2024 Location: MIAMI, FL, US, 33101 The State Personnel System is an E-Verify employer. For more ... No: 825559 Agency: Office of Financial Regulation Working Title: FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004823 Pay Plan: Career Service Position Number:… more
- MyFlorida (Miami, FL)
- … Fraud Examiner (CFE) certification through the Association of Certified Fraud Examiners (ACFE); Certified Financial Crimes Investigator (CFCI) through the ... FINANCIAL INVESTIGATOR -CONSUMER PROTECTION - 41000562 Date: Mar 28, 2024...Consumer Protection Division's mission is to protect consumers from fraud and other financial exploitation, to prevent and stop… more
- MyFlorida (Tallahassee, FL)
- LAW ENFORCEMENT INVESTIGATOR II - 41000785 Date: Apr 23, 2024 Location: TALLAHASSEE, FL, US, 32399 The State Personnel System is an E-Verify employer. For more ... Office of the Attorney General Working Title: LAW ENFORCEMENT INVESTIGATOR II - 41000785 Pay Plan: Career Service Position...Annually Position Summary: This position is in the Medicaid Fraud Unit. The Attorney General's Medicaid Fraud … more
- State of Massachusetts (Boston, MA)
- …money and property. The OIG is an independent agency charged with preventing and detecting fraud , waste and abuse in the use of public funds and public property. By ... Together the bureaus work to prevent and detect waste, fraud and abuse of public resources in the Commonwealth....when no crime or civil action is involved. *Senior Investigator : Position Overview* The Senior Investigator reports… more
- CVS Health (Springfield, IL)
- … Fraud Examiners (CFE), or an accreditation from the National Health Care Anti- Fraud Association (AHFI)*Knowledge of Aetna's policies and ... personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of...*Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations.… more
- Highmark Health (Columbus, OH)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... related field **EXPERIENCE** **Required** + 5 years in the Health insurance industry and/or Healthcare fraud investigations...in the Health insurance industry and/or Healthcare fraud investigations + 1 year of leading projects of… more
