- Command Investigations (Cleveland, OH)
- …to conduct SURVEILLANCE as it relates to the investigation of suspect insurance claims . We are seeking individuals who possess proven investigative skill sets within ... Requirements: + 1+ years of experience as an Surveillance Investigator + Must be licensed as a Private ...your state (if required) + Flexibility to work varied/irregular hours and days including weekends and holidays + Valid… more
- Humana (Dayton, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program integrity … more
- CVS Health (Columbus, OH)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- CVS Health (Columbus, OH)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known or ... fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business +...health care fraud, waste and abuse investigations). **Anticipated Weekly Hours ** 40 **Time Type** Full time **Pay Range** The… more
- Humana (Columbus, OH)
- …Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate ... for training or meetings may be required. **Scheduled Weekly Hours ** 40 **Pay Range** The compensation range below reflects...estimate of starting base pay for full time (40 hours per week) employment at the time of posting.… more
- CVS Health (Columbus, OH)
- …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more