- Insight Global (Norfolk, VA)
- …Our client is seeking two contract-to-hire professionals to join their team as Claims Investigators / Process Specialists. These roles are pivotal in ensuring the ... accuracy and efficiency of claims processing. Key Responsibilities: -Develop Solutions: Create and implement processes to address overpaid claims challenged by… more
- AIG (Atlanta, GA)
- …AIG, we are reimagining the way we help customers to manage risk. Join us as a Senior Claims Investigator to play your part in that transformation. It's an ... service with empathy and efficiency. How you will create an impact The Senior Claims Investigator is responsible for all aspects of the investigation process… more
- Allied Solutions (Plano, TX)
- …and exceed all established recovery and claim service standards and benchmarks for a Claims Investigator . + Promptly and effectively respond to both carrier and ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- EFI Global (Los Angeles, CA)
- …Click here to learn more about EFI Global. Seeking a certified fire investigator in the greater Los Angeles area. Must hold IAAI-CFI certification. **PRIMARY ... buildings or residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large… more
- EFI Global (Detroit, MI)
- …buildings or residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud, this includes large loss, large ... fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported back to the requesting party in adherence to best practices.… more
- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will… more
- CVS Health (Bismarck, ND)
- …anywhere in the United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- CVS Health (Morgantown, WV)
- …each and every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of ... or intricate healthcare fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares… more
- Blue KC (Kansas City, MO)
- …to peers and clinical standards, etc. In conjunction with the Manager and/or Senior Investigator , evaluate FWA risks and prioritize for further review, based ... in accordance with SIU policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations. + Create and maintain… more
- The Boeing Company (Ridley Park, PA)
- …your future with us. **Boeing Defense Space & Security** **(BDS)** is looking for a ** Senior (Level 4 or Level 5) System Safety Engineer** to join our team onsite in ... + Participates in the discussion of legal cases and claims with in-house and outside counsel. + Researches, acquires...market and business considerations. **Summary Pay Range** : + Senior (Level 4): $129,200 - $174,800 + Senior… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive ... practices. The Senior Fraud and Waste Professional work assignments involve moderately...CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in… more
- Manulife (Workman, MN)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... plan + Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of insureds, caregivers, and other involved parties + Handles third party vendor(s) conducting long term care surveillance activities… more
- Manulife (NY)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative ... plan + Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of insureds, caregivers, and other involved parties + Handles third party vendor(s) conducting long term care surveillance activities… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... recommendations. 5. In conjunction with the assigned Incident Management Investigator Specialist, prepares investigative reports and forwards completed reports to… more
- Constructive Partnerships Unlimited (Manhattan, NY)
- Incident Management Investigator Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6481) Job Brief Assists the Incident Management Investigator with conducting investigations into situations, which may violate… more
- United Therapeutics (Research Triangle Park, NC)
- …part of a company that is forward thinking and innovative. The Senior /Statistical Scientist, Global Medical Affairs will contribute to all biostatistical and ... team and other stakeholders to provide biostatistical resources for investigator -sponsored clinical studies and address internal/external investigator queries… more
- Mount Sinai Health System (New York, NY)
- …Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible ... to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The… more
- Otsuka America Pharmaceutical Inc. (Annapolis, MD)
- The Senior Director Translational Medicine will be responsible for design, execution and reporting of First in Human (FIH), Translational Medicine (TM) and Proof of ... and scientific capabilities in support of Otsuka's pipeline. The Senior Director TM works closely with Head of TM...plans. + Review and approval of clinical study protocols, investigator brochures, study reports, etc. + Support budget and… more
- University of Southern California (Los Angeles, CA)
- …excellence, and private and public sector engagement, is looking for a Senior SAS Research Programmer to provide programming support on research projects examining ... health behavior research and related health policy topics. The Senior SAS Research Programmer will serve as lead programmer and technical specialist on research… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Senior Clinical Risk Manager The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote patient ... loss to protect the assets of the facility. The Senior Risk Manager supports the Risk Management staff on...with the HRA/TDC on-site Professional Liability Investigators: reporting potential claims as well as cases of concern by preparation… more