- State of Georgia (Fulton County, GA)
- Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot ... of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the...proper diagnostic and procedure codes were used in submitting claims to the Georgia Medicaid Program. Maintains a comprehensive… more
- Elevance Health (Atlanta, GA)
- **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of… more
- Highmark Health (Atlanta, GA)
- …or alleged fraud/waste and abuse cases or special projects. + Provides advisory support as needed to internal and external law enforcement and regulatory agencies, ... Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …and all affiliates are inspection ready, oversee clinical trial and submission support , lead the R&D audit program, engage with regulatory authorities, and maintain ... of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including contract research organizations) and ensure that… more
- CVS Health (Atlanta, GA)
- …**Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more