- Summa Health (Akron, OH)
- …one (1) years of experience reviewing medical records c. Accredited Healthcare Fraud Investigator (AHFI) certification preferred. d. Special Investigations Unit ... RN Special Investigations Unit (SIU) Investigator SummaCare - 1200 E Market St, Akron,...rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service… more
- State of Georgia (Fulton County, GA)
- Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67636/other-jobs-matching/location-only) Hot ... Sign Up for Job Alerts The Office of the Attorney General Department of Law Medicaid Fraud Division - Investigator The mission of the Department of Law is to… more
- State of Georgia (Fulton County, GA)
- …for Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the recruiting ... Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot...announcement will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the… more
- State of Michigan (Macomb, MI)
- Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG - Macomb Co Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4924560) Apply ... Regulation Agent 9-P11 ( Fraud Investigator ) - MDHHS OIG - Macomb Co Salary $1,996.00 - $3,063.20 Biweekly Location Macomb, MI Job Type Permanent Full Time Remote… more
- Humana (Oklahoma City, OK)
- …Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of Investigators conducts ... Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve...contact for OHCA and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate… more
- CVS Health (Hartford, CT)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- MyFlorida (Tallahassee, FL)
- …Position Summary: This position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tallahassee, Florida. This position is in the ... LAW ENFORCEMENT INVESTIGATOR II - 41000710 Date: Jul 10, 2025 The State Personnel...Medicaid Fraud Unit. The Attorney General's Medicaid Fraud Control… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The DSS Accountability ... SOS 366-a(2)(a). MID review cases identified as susceptible to fraud and examine Medicaid enrollee documents found...state data sources. BFI is recruiting for three (3) Fraud Investigator II to function as Senior… more
- Molina Healthcare (St. Petersburg, FL)
- …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
- 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 ... Investigator /Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4951050) Apply Investigator /Special Agent 1-4 Salary… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE The DSS Accountability Office (DSS-AO) is responsible for protecting ... also responsible for evaluating and assessing the resources of Medicaid Nursing Home residents through computer bank matches, assessing...levels. Claims and Collections (C&C) is recruiting (1) one Fraud Investigator II to function as a… more
- State of Nevada (NV)
- …specific program or regulatory area which includes, but is not limited to, Medicaid fraud , workers' compensation fraud , consumer protection, public ... AG CRIMINAL INVESTIGATOR 2 APPROXIMATE ANNUAL SALARY - $83,666.16 to...integrity, human trafficking, missing children, financial fraud , alleged criminal offenses committed by State officers or… more
- CVS Health (Carson City, NV)
- …Care Anti- Fraud Association (AHFI), or have a minimum of three years Medicaid Fraud , Waste and Abuse investigatory experience. + Billing and Coding ... it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and… more
- CVS Health (Annapolis, MD)
- …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. - Conducts investigations of known...Must be located in Maryland. - Knowledge of Maryland Medicaid - State Of Maryland- Maryland Department of Health… 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 Bureau of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; Certified Compliance and Ethics Professional,… more
- MyFlorida (Miami, FL)
- …30% Serve as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud involving: 1) ... Summary:This position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami or West Palm Beach, Florida, and involves auditing… more
- Corewell Health (Grand Rapids, MI)
- …experience with a managed care payer. Preferred + Preferred + CRT-Accredited Health Care Fraud Investigator (AHFI) - NHCAA National Health Care Anti- Fraud ... a focus on identifying, investigating, and resolving health insurance fraud , waste, and abuse (FWA). This role provides operational... and abuse, compliance, or regulatory (ie, CMS & Medicaid ) experience Required + 5 years of relevant experience… more
- Aveanna Healthcare (Homestead, FL)
- …to individual approved protocols. Complete clinical trial visits on-site with investigator teams, or in an off-site capacity, working remotely visiting patients' ... (RNPM), Research nurse manager, site staff and the Principal Investigator , to ensure a smooth and efficient flow of...that may be required Report any suspected misconduct or fraud to Aveanna & Illingworth and associated companies Where… more
