• Investigator

    Highmark Health (Austin, TX)
    …**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)
    - Related Jobs
  • Fraud Investigations Analyst

    Guidehouse (Richardson, TX)
    …gain employment with our rapidly growing firm. Guidehouse is seeking experienced Fraud Investigations Analyst's to conduct, identify, and investigate potential ... document and escalate such matters. The responsibilities of the Fraud Investigations Analyst will include, but are...workplace. Benefits include: + Medical, Rx, Dental & Vision Insurance + Personal and Family Sick Time & Company… more
    Guidehouse (07/18/25)
    - Related Jobs
  • Clinical Fraud Investigator II

    Elevance Health (Houston, TX)
    …Certificate or Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance Health only accepts resumes ... **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role...clinical evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims… more
    Elevance Health (08/30/25)
    - Related Jobs
  • Senior Manager, EBT Fraud Analytics…

    Conduent (San Antonio, TX)
    …incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and ... investigators, and internal stakeholders to ensure timely and effective fraud prevention. **Key Responsibilities** + Lead investigations ...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
    Conduent (07/30/25)
    - Related Jobs
  • CAG - Fraud Investigation Services…

    Conduent (San Antonio, TX)
    …incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and ... be part of a culture where individuality is noticed and valued every day. ** Fraud Investigation Services Associate III** **$19.50 per hour** As a ** Fraud more
    Conduent (08/28/25)
    - Related Jobs
  • Certified Professional Coder, Special…

    CVS Health (Austin, TX)
    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)
    - Related Jobs
  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Austin, TX)
    …& 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)
    - Related Jobs
  • Area Loss Prevention Manager (ALPM) - Nationwide

    Ross Stores, Inc. (Dallas, TX)
    …and Store Manager, are eligible for extended benefits offered including Medical/Dental/Vision Health Insurance , Legal Insurance , Vacation Buy, Flexible ... Spending Account, Health Savings Account, Life/ADD Insurance , Long\- Term Disability, Enhanced Maternity and Parental Leave Benefit, Vacation Pay accrued at a… more
    Ross Stores, Inc. (08/08/25)
    - Related Jobs
  • Clinical Provider Auditor II

    Elevance Health (Houston, TX)
    …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an Impact:** + Examines claims for ... compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and conducts analysis… more
    Elevance Health (08/26/25)
    - Related Jobs
  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    …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)
    - Related Jobs