- Zurich NA (Tallahassee, FL)
- …and internal controls throughout the claims process. + Identify and refer claims with subrogation or fraud potential to the appropriate internal teams for ... organizations. **This role will be filled at either the** **Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate… more
- Humana (Tallahassee, FL)
- **Become a part 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...Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- The Senior Manager , Global Product Quality - Biologics is responsible for managing quality oversight of clinical and commercial products at CMOs under contract by ... for use in clinical studies and commercial supply. + Reviews/approves deviations, investigations , CAPA plans and change controls per Otsuka Policies and Procedures.… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- The ** Manager , Manufacturing Product Quality (Small molecule)** is responsible for ensuring **GMP compliance** in the manufacturing packaging, labeling, and ... maintained throughout the commercial and clinical supply chains. The manager will collaborate with cross-functional teams including Clinical Operations, Regulatory… more
- Kemper (Doral, FL)
- …oral and written communications skills and promote a favorable company image to the public. + Fraud Claims Law Specialist (FCLS) or Fraud Claims Law ... SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and...of all critical situations. + Reports findings of all investigations and makes recommendations to the responsible manager… more
- CDM Smith (Jacksonville, FL)
- …CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial ... data related to disaster-related claims , including property damage, business interruption, and other loss...other loss categories. The specialist will conduct thorough forensic investigations to identify discrepancies, detect potential fraud ,… more
- Elevance Health (Lake Mary, FL)
- …AHFI, CPC, Paralegal, RN, JD or Law Enforcement preferred. + Pharmacy claims , records and investigations , experience strongly preferred. + Pharmacy technician ... and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- CVS Health (Tallahassee, FL)
- …develop, and maintain complex data analyses to support investigations of potential fraud , waste, and abuse in Medicaid claims and provider activity. + ... who can transform complex healthcare data into actionable insights to support fraud , waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting.… more