- Molina Healthcare (Rochester, NY)
- …reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review ... Counsel, and Medical Officers in order to achieve and maintain appropriate anti- fraud oversight. **Job Duties** + Responsible for developing leads presented to the… more
- CVS Health (Albany, NY)
- …investigators and analysts to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to ... a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and counsel on… more
- Highmark Health (Albany, NY)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- Amentum (Albany, NY)
- …data analytics. + Support development of internal best practices and workflows for healthcare fraud detection. **Required Qualifications:** + Must be able to ... business entities, and assets. + Analyze large and complex healthcare claims datasets to identify fraud , waste, and abuse patterns. + Design and run SQL… more
- New York State Civil Service (New York, NY)
- …approximately eight to ten investigators assigned to investigate insurance, financial and healthcare fraud across upstate and downstate regions.The duties of ... * Establishes goals and priorities for investigations involving diverse fraud schemes and other emerging criminal activity affecting insurance, financial… more
- Elevance Health (Latham, NY)
- …independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client ... claims. + Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one… more
- DoorDash (New York, NY)
- …team is looking for an Associate Manager to reduce the cost of fraud and build solutions to protect our platform from would-be fraudsters. You'll specifically ... creating our strategy and executing against ambitious goals around preventing Merchant fraud . You'll grow familiar with our three audiences - Consumers, Dashers and… more
- Legal Services of the Hudson Valley (Monticello, NY)
- …stake including: eviction and foreclosure prevention, domestic violence, disability, elder law, healthcare , consumer fraud and more. Our services support almost ... 600,000 poor and low-income families and individuals who cannot afford an attorney in our seven-county service area. With the gap separating those who can and cannot afford legal representation widening each day, we work to ensure that everyone has equal… more
- Legal Services of the Hudson Valley (White Plains, NY)
- …stake including: eviction and foreclosure prevention, domestic violence, disability, elder law, healthcare , consumer fraud and more. Our services support almost ... 600,000 poor and low-income families and individuals who cannot afford an attorney in our seven-county service area. With the gap separating those who can and cannot afford legal representation widening each day, we work to ensure that everyone has equal… more
- Legal Services of the Hudson Valley (Yonkers, NY)
- …stake including: eviction and foreclosure prevention, domestic violence, disability, elder law, healthcare , consumer fraud and more. Our services support almost ... 600,000 poor and low-income families and individuals who cannot afford an attorney in our seven-county service area. With the gap separating those who can and cannot afford legal representation widening each day, we work to ensure that everyone has equal… more