- PNC (Pittsburgh, PA)
- …initiatives. Strong understanding of technology, general controls, and other financial product controls Certified Fraud Examiner ( CFE ), Certified ... be performed remotely, at manager's discretion. Responsibilities Demonstrated knowledge of Fraud related risks and a solid business understanding of application of… more
- Guardian Life (Bethlehem, PA)
- …financial services fraud investigations + Series 7 and CAMS and/or CFE designation strongly preferred (or willingness to obtain certification within 18 months of ... spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and...but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The ... Manager, Fraud and Waste works within specific guidelines and procedures;...Certifications (BA, MBA, JD, MSN, Clinical Certifications, CPC, CCS, CFE , AHFI) + Understanding of healthcare industry, claims processing… more
- Highmark Health (Harrisburg, PA)
- …Contracting **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner ( CFE ) + Certified ... Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment… more
- Highmark Health (Pittsburgh, PA)
- …Reimbursement or Provider Contracting **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Certified Fraud Examiner ( CFE ) + Certified ... Professional Coder (CPC) + Certified Professional Coder- Hospital(CPC-H) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI)… more
- Prime Therapeutics (Harrisburg, PA)
- …CPT/HCPS/Revenue codes, insurance terms and policy interpretation. + CFE - Certified Fraud Examiner credential preferred. + Bachelor's degree preferred. ... for the intake and initial handling of allegations of fraud , waste or abuse. Conducts preliminary investigation to assess...audit or investigation. Serves as a corporate resource on fraud , waste and abuse issues and maintains confidentiality and… more
- CDM Smith (Harrisburg, PA)
- …required. **Preferred Qualifications:** * Certification such as CPA ( Certified Public Accountant), CFE ( Certified Fraud Examiner ), or CFF ( ... CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims. This role is critical in evaluating and analyzing financial data… more
- Citizens (Pittsburgh, PA)
- …Certifications - Certified Internal Auditor (CIA), Accredited Payments Risk Professional (APRP), Certified Fraud Examiner ( CFE ), Certified Anti ... Money Laundering Specialist (CAMS) Hours & Work Schedule: Hours per Week: 40 Work Schedule: M-F 8-5 Pay Transparency: The salary range for this position is $112,064-$200,000 per year, plus an opportunity to earn an annual discretionary bonus. Actual pay is… more
- Highmark Health (Pittsburgh, PA)
- …+ Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner ( CFE ) + Certified Healthcare Constructure ... (CHC) + Certified Compliance & Ethics Professional (CCEP) **SKILLS** + Broad-based business knowledge as well as in-depth knowledge of the insurance industry, strategic compliance planning, regulatory concerns, compliance requirements, and corporate… more
- Highmark Health (Pittsburgh, PA)
- …+ Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner ( CFE ) + Certified Information Systems ... Auditor (CISA) **SKILLS** + Knowledge of internal audit functions, including the ability to apply auditing (GAAS), accounting (GAAP) and or industry standards to the evaluation of operational/financial/compliance audits + Exhibiting effective resource and… more