- Elevance Health (Costa Mesa, CA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Highmark Health (Sacramento, CA)
- …**EXPERIENCE** **Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations ... in Financial Analysis in an acute care hospital or health insurance setting + 1 year in...(CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have… more
- Elevance Health (Rancho Cordova, CA)
- …of benefit programs management with heavy emphasis in negotiation preferred. + Health insurance , law enforcement experience preferred. + Pharmacy technician ... ** Investigator II** **Location Hybrid 1** : This role...investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds… more
- Elevance Health (Los Angeles, CA)
- … in order to recover corporate and client funds paid on fraudulent claims. Health insurance experience required with understanding of health insurance ... ** Investigator Senior** **Supports the Payment Integrity line of...Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity,… more
- Command Investigations (Walnut Creek, CA)
- … insurance , PTO, 401(k) + Performance incentives + Biweekly pay Benefits: + 401(k) + Dental insurance + Health insurance + Vision insurance + Life ... you'll get: + A dedicated position as a surveillance investigator on a full- time basis. + A steppingstone...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Hold a valid Private… more
- EFI Global (Los Angeles, CA)
- …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 ... residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud , this includes large loss, large fire loss,… more
- Banc of California (Santa Ana, CA)
- …company's 401k plan which includes a company match and immediate vesting. + ** Health & Well-Being:** We offer comprehensive insurance options including medical, ... risk and producing financial intelligence through research and analysis. The EDD Investigator I will conduct analyses of current customers through a variety of… more
- Centene Corporation (Sacramento, CA)
- …per year Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- Banc of California (Santa Ana, CA)
- …company's 401k plan which includes a company match and immediate vesting. + ** Health & Well-Being:** We offer comprehensive insurance options including medical, ... to detect transactions that involve potential financial criminal activity, such as fraud , money laundering or terrorist financing. + Documents and reports the… more
- Marriott (Chula Vista, CA)
- …outside medical treatment. Conduct investigations and gather evidence related to theft/ fraud or lost items, noise complaints, assault complaints, food poisoning ... and other guest complaints and incidents. Assist manager/supervisor in ensuring insurance carrier is notified of liability situations according to designated… more