- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation with law enforcement… more
- Molina Healthcare (Albany, NY)
- …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
- Molina Healthcare (Albany, NY)
- …delivery systems + Understanding of datamining and use of data analytics to detect fraud , waste , and abuse + Proven ability to research and interpret regulatory ... position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position… more