- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive ... practices. The Fraud and Waste Professional 2 work assignments are varied...independent determination of the appropriate courses of action. The Fraud and Waste Professional 2 coordinates investigation with law… more
- Molina Healthcare (Columbus, OH)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse . Duties include performing accurate and reliable… more
- Highmark Health (Columbus, OH)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… more
- Molina Healthcare (Columbus, OH)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse . Duties include performing accurate and reliable ... may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to...and/or health plan members in order to determine whether fraud , waste, or abuse may have occurred.… more
- Meta (Columbus, OH)
- …bad actors from abusing the platform. You will investigate holistic networks of abuse to understand and deter adversaries, and then scale solutions that precisely ... to protect Meta users from harm. **Required Skills:** Technical Investigator , Integrity Operations Responsibilities: 1. Apply quantitative skills and incorporate… more
- Sedgwick (Columbus, OH)
- …or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), or Certified Fraud Examiner (CFE) strong ... software and databases + Strong knowledge of laws related to fraud , abuse , investigation, and state insurance reporting + Expert witness, deposition, and… more