- Humana (Richmond, VA)
- …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 (Richmond, VA)
- …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
- Prime Therapeutics (Richmond, VA)
- …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
- ManTech (Herndon, VA)
- …for sensitive matters. **Preferred Qualifications:** + Progress towards or completion of the Certified Fraud Examiner ( CFE ) certification, Certified ... and other necessary corrective actions or remedial measures. + Participate in fraud awareness training and skill development programs to support and improve… more
- Capital One (Mclean, VA)
- …Administration + Professional Certification such as Certified Anti-Money Laundering Specialist (CAMS), Certified Fraud Examiner ( CFE ), Certified ... strategy to ensure the quality of AML, Sanctions and Fraud risk management is effective across all lines of...Auditor (CIA), Certified Public Accountant (CPA), or Certified Regulatory Compliance Manager (CRCM) + Experience with consumer… more
- Capital One (Richmond, VA)
- …Laundering (AML) experience - Association of Certified Anti-Money Laundering Specialists (ACAMS), Certified Fraud Examiner ( CFE ), Certified ... GED or equivalent certification -At least 1 year of fraud , or at least 1 year of Anti-Money Laundering...(AML) experience **Preferred Qualifications:** -Bachelor's degree -2+ years of fraud experience, or 2+ years of investigative experience, or… more
- CDM Smith (Richmond, VA)
- …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
- Amentum (Vienna, VA)
- …+ Additional certification, such as CAMS ( Certified Anti-Money Laundering Specialist) or CFE ( Certified Fraud Examiner ) is preferred. **CONUS and ... OCONUS Travel may be Required** Amentum is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, sex, sexual orientation, pregnancy (including pregnancy, childbirth, breastfeeding, or… more
- Guidehouse (Sterling, VA)
- …Enforcement, Defense, and/or the + Certified Public Accountant licensure (CPA) or Certified Fraud Examiner ( CFE ) certification + Intelligence ... Community on federal government case investigations + Experience conducting digital asset/cryptocurrency analysis + Chainalysis or other digital asset/cryptocurrency analysis certification + Experience conducting open-source research and analysis, as well as… more
- Highmark Health (Richmond, VA)
- …+ Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner ( CFE ) + Certified in Healthcare ... Compliance (CHC) + Certified Compliance and 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… more