• Investigator, Special Investigative Unit-Must…

    Molina Healthcare (Lexington, KY)
    …Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are ... reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review… more
    Molina Healthcare (08/28/25)
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  • Investigator

    Highmark Health (Frankfort, KY)
    …or CERTIFICATIONS** **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified ... :** **JOB SUMMARY** This job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training and filing of … more
    Highmark Health (08/15/25)
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  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Frankfort, KY)
    …CPT/HCPS/Revenue codes, insurance terms and policy interpretation. + CFE - Certified Fraud Examiner credential preferred. + Bachelor's degree preferred. + Prefer ... for the intake and initial handling of allegations of fraud , waste or abuse. Conducts preliminary investigation to assess...audit or investigation. Serves as a corporate resource on fraud , waste and abuse issues and maintains confidentiality and… more
    Prime Therapeutics (06/24/25)
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  • Senior Managing Director, Risk Advisory, Global…

    Ankura (KY)
    …and ongoing professional education in both accounting (CPA strongly preferred), and fraud examination (Certified Fraud Examiner , Certified in Financial ... Accounting team assists companies with addressing issues related to corruption, fraud , or accounting misstatements. We offer clarity and guide decision-making during… more
    Ankura (09/03/25)
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  • Manager, Special Investigative Unit-Kentucky

    Molina Healthcare (Covington, KY)
    …Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE) **Preferred Education** Master's Degree preferred; will ... + Works with leadership to maintain and revise policies and procedures, fraud , waste, and abuse plans, annual audit work plans, including department guidance… more
    Molina Healthcare (07/18/25)
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  • FEMA Disaster Management Accountant

    CDM Smith (Bowling Green, KY)
    …Qualifications:** * Certification such as CPA (Certified Public Accountant), CFE (Certified Fraud Examiner ), or CFF (Certified in Financial Forensics). **EEO ... CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims. This role is critical in evaluating and analyzing financial data… more
    CDM Smith (08/01/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Frankfort, KY)
    …+ Certified Public Accountant (CPA) + Certified Internal Auditor (CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified ... Compliance and Ethics Professional (CCEP) **SKILLS** + Broad-based business knowledge as well as in-depth knowledge of the insurance industry, strategic compliance planning, regulatory concerns, compliance requirements, and corporate integrity principles. +… more
    Highmark Health (07/29/25)
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  • Claims Care Associate

    Lincoln Financial (Frankfort, KY)
    …You will act as a liaison between the employee (member) and the claims examiner to provide a positive customer experience during their specific challenge. As a ... offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at ###@lfg.com if you encounter a recruiter or see a job… more
    Lincoln Financial (09/04/25)
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  • Claims Specialist

    Kelly Services (Frankfort, KY)
    …compliance with client guidelines + Identifies and investigates for possible fraud , subrogation, contribution, recovery, and case management opportunities to reduce ... or email ###@kellyservices.com!** Related job titles: Claims Manager, Claims Supervisor, Claims Examiner , Claims Analyst, Claims Associate \#P1 \#CB As part of our… more
    Kelly Services (08/08/25)
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