- MyFlorida (Tallahassee, FL)
- …design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data ... include, but not be limited to, the following: * Identify suspicious patterns in claims data and other sources by applying your knowledge of heath care coding… more
- MyFlorida (Alachua, FL)
- …Field Office Open Competitive Opportunity Your Specific Responsibilities: The investigator conducts priority and routine investigations, audits and inspections ... violation of Florida Statutes and rules governed by the Agency. The investigator must provide investigative results through the collection of evidence and… more
- Kemper (Doral, FL)
- …College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong ... and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA)… more
- CVS Health (Tallahassee, FL)
- …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
- Mayo Clinic (Jacksonville, FL)
- …purpose to allow qualified individuals to work within an established investigator 's program in preparation for an academic and/or independent research career. ... working with healthcare services or healthcare delivery data, including administrative claims and EHR data, and healthcare quality outcomes research strongly … more