- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
- CVS Health (Columbus, OH)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated ... to a specific self-funded plan sponsor. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected… more
- AmeriHealth Caritas (Columbus, OH)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... **Major Accountabilities:** + Ensures compliance with all requirements related to Special Investigation Units and fraud, waste and abuse investigations. + Conducts… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position… more
- City of Columbus (Columbus, OH)
- Refuse Compliance Investigator - EXAM Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/5128594) Apply Refuse Compliance Investigator - ... Assists in coordinating refuse collection services provided by the City for special events; + Assists route supervisor on planning and implementing refuse collection… more
- Family Dollar (Marysville, OH)
- General Summary: The Market Investigator is responsible for confirming that the market's stores operations and daily functions comply with Company programs and ... suspected fraudulent activity to Loss Prevention Business Partners. + Assist with special projects that impact given market (ie Target Program and Shrink Impact… more
- Parexel (Columbus, OH)
- …to design, development and implementation of major business initiatives or special projects. Applies technical skills and discipline knowledge to contribute to ... achievement of client business objectives **Compliance with Parexel standards** + Complies with required training curriculum + Completes timesheets accurately as required + Submits expense reports as required + Updates CV as required + Maintains a working… more
- CVS Health (Columbus, OH)
- …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. What you will do - Routinely handles cases involving behavioral health or multi-disciplinary provider groups in a… more
- Pfizer (Columbus, OH)
- …researchers as appropriate + Appropriately provide medical support throughout the Investigator Sponsored Research (ISR) process + Cultivate research and therapeutic ... - Onboarding partner, ad board and study lead mentor. + Participate in special projects as needed **BASIC QUALIFICATIONS** + Candidate demonstrates a breadth of… more