- State of Georgia (Fulton County, GA)
- Criminal Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73115/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
- State of Michigan (Oakland, MI)
- Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG (Oakland County) Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5145616) Apply ... Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG (Oakland County) Salary $2,056.00 - $3,155.20 Biweekly Location Oakland, MI Job Type Permanent Full Time… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- Social Services Investigator - Fraud and Resources Hybrid Recruitment # 251118-5042SH-001 Location Bridgeport, CT Danbury, CT Hartford, CT Manchester, CT New ... talented current DSS employees to fill multiple Social Services Investigator - Fraud and Resources (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5042SH&R1=&R3=) opportunities. These opportunities… more
- Idaho Division of Human Resources (Boise, ID)
- …Working knowledge of Medicaid regulations and healthcare billing practices. + Criminal Investigator Minimum Qualifications: Must have and maintain Idaho POST ... Criminal Investigator or Investigative Auditor, OAG,...they depend. This position is responsible for conducting complex criminal investigations involving Medicaid provider fraud… more
- MyFlorida (Tampa, FL)
- …Investigator II position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tampa, Florida. The Attorney General's Medicaid ... the Medicaid Program, false claims against the Medicaid program, investigating possible criminal violations of...investigations of alleged violations of applicable laws pertaining to Medicaid fraud in the administration of the… more
- State of Georgia (Fulton County, GA)
- Intake Coordinator- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72587/other-jobs-matching/location-only) Hot ... announcement will serve in the Investigations Section of our Medicaid Fraud & Patient Protection Division. Duties...procedures; (2) state laws and rules governing the Georgia Medicaid program; and (3) criminal laws and… more
- Louisiana Department of State Civil Service (LA)
- …and provides investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud ... other Medicaid providers. The MFCU holds offenders accountable through criminal prosecution and civil litigation. From inception through disposition, the nurse… more
- Molina Healthcare (Macon, GA)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
- AmeriHealth Caritas (Columbus, OH)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... alleged or suspected fraud involving the full range of products at the...information which would be considered admissible under generally accepted criminal and civil rules of evidence. + Proactively performs… more
- CVS Health (Morgantown, WV)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known or ... suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive...to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... Workplace** . **Qualifications you'll bring:** + BA/BS degree in criminal justice or a related field, and minimum of...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
- Molina Healthcare (Cincinnati, OH)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible for ... also responsible for evaluating and assessing the resources of Medicaid Nursing Home residents through computer bank matches. Claims...allowable levels. C&C is recruiting for (1) one Associate Fraud Investigator II to function as a… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Office of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
- MyFlorida (Miami, FL)
- …reports, findings, audits, and investigations in MPI's fight in the prevention of Medicaid fraud and abuse. The incumbent will prepare and review settlement ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid...a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Office of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
- MyFlorida (Miami, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... about legal proceedings and investigations related to health care fraud and abuse. The Florida Medicaid program...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional, or other relevant certification, such… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; or Certified Compliance and Ethics… more