- CVS Health (Tallahassee, FL)
- …investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state ... regulations mandating fraud plans and practices. What you will do -...the recovery of company lost as a result of fraud matters. - Assists team in identifying resources and… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training and filing of ... Fraud Plans and Reports. The incumbent is responsible for...investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… more
- MyFlorida (Miami, FL)
- …EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: PUBLIC ASSISTANCE FRAUD CITY: MIAMI COUNTY: MIAMI-DADE The Criminal Investigations Division ... investigates a wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation Fraud Investigations + Fire, Arson,… more
- Bank of America (Tampa, FL)
- …Key responsibilities include conducting routine to complex investigations, including fraud committed by external parties, money laundering, or terrorist financing ... in an investigative support role **Skills:** + Critical Thinking + Fraud Management + Regulatory Compliance + Written Communications + Investigation Management… more
- MyFlorida (Miami, FL)
- …is in the Office of the Attorney General within the Medicaid Fraud Unit in Miami, Florida. Pay:$60,000.20 - $62,425.00 Annually Qualifications: Florida Statute ... lawenforcement experience, or five (5) years of workexperience conducting healthcare fraud investigations. Note: All newly hired employees must obtain CJSTC Sworn… more
- Allied Universal (St. Petersburg, FL)
- …must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for ... professional law enforcement experience with specific attention to investigations related to fraud + Ability to be properly licensed as a Private Investigator as… more
- Kemper (Doral, FL)
- …* Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong communication/interpersonal skills + ... data and develop processes for scrubbing reports for potential fraud + Completion of the NICB Basic and/or Analytics...Basic and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist… more
- Prime Therapeutics (Tallahassee, FL)
- …Description** Responsible for the intake and initial handling of allegations of fraud , waste or abuse. Conducts preliminary investigation to assess the merit of ... to recommend for audit or investigation. Serves as a corporate resource on fraud , waste and abuse issues and maintains confidentiality and compliance with HIPAA… more
- MyFlorida (Miami, FL)
- …States. The Consumer Protection Division's mission is to protect consumers from fraud and other financial exploitation, to prevent and stop unfair and deceptive ... investigations may include allegations of unfair and deceptive trade practices, consumer fraud , asset forfeiture, organized schemes to defraud, and fraud … more
- Finexio (Orlando, FL)
- …assistance in managing our Client Operations, Onboarding and Implementation and Fraud Prevention and Compliance functions. The ideal candidate will bring process ... and Engineering to optimize implementation timelines and client outcomes. Fraud Prevention & Compliance + Manage Fraud ...outcomes. Fraud Prevention & Compliance + Manage Fraud Prevention processes and enhance our Fraud … more