• Investigator

    Highmark Health (Springfield, IL)
    …**Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year ... fraud , waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to...in Financial Analysis in an acute care hospital or health insurance setting + 1 year in… more
    Highmark Health (08/15/25)
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  • Certified Professional Coder, Special…

    CVS Health (Springfield, IL)
    At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...federal policies. - Identify potential billing errors, abuse, and fraud . - Identify opportunities for savings related to potential… more
    CVS Health (08/24/25)
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  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Springfield, IL)
    …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage workload while… more
    Prime Therapeutics (06/24/25)
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  • Clinical Provider Auditor II

    Elevance Health (Chicago, IL)
    …by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and… more
    Elevance Health (08/13/25)
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  • Senior Risk Partner - Compliance Officer

    Highmark Health (Springfield, IL)
    …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... Program including auditing/monitoring operational processes, conducting or overseeing compliance investigations , and ensuring that adequate training takes place under… more
    Highmark Health (07/29/25)
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  • Surveillance Investigator - Experienced

    Command Investigations (Chicago, IL)
    insurance , PTO, 401(k) + Performance incentives + Biweekly pay Benefits: + 401(k) + Dental insurance + Health insurance + Vision insurance + Life ... Command Investigations LLC is a dynamic and forward-thinking investigative...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Be able to hold… more
    Command Investigations (06/16/25)
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  • Senior Director, MSAT Biologics

    Otsuka America Pharmaceutical Inc. (Springfield, IL)
    …process performance, troubleshooting, and improvements. + Lead complex manufacturing investigations and deviations, ensuring thorough root cause analysis and ... strategies and optimize product lifecycle management + Lead root cause investigations for manufacturing deviations and implement corrective and preventive actions +… more
    Otsuka America Pharmaceutical Inc. (07/15/25)
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  • Forensic Structural Engineer, PE

    EFI Global (Springfield, IL)
    …the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a ... limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and… more
    EFI Global (08/14/25)
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  • Forensic Electrical Engineer, PE

    EFI Global (Springfield, IL)
    …the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a ... limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and… more
    EFI Global (08/14/25)
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  • Sr. Consultant, Operational Risk

    CIBC (Chicago, IL)
    …Innovation (US TI&I) spans the areas of Technology, Information Security, Fraud Management, Corporate Investigations , Deposit Operations, Loan Operations, ... benefits and programs to meet our employee's needs; including Medical, Dental, Vision, Health Savings Account, Life Insurance , Disability, and Other Insurance more
    CIBC (08/20/25)
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