- Molina Healthcare (FL)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- CVS Health (Tallahassee, FL)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud , waste, and abuse (FWA) detection and Medicaid… more
- CVS Health (Tallahassee, FL)
- …this role, you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + ... Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse . + Conduct Investigations to prevent payment of… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Analyst - Fraud , Waste & Abuse (FWA) provides leadership in in the investigation of potential FWA cases; its main goal is aimed at ... detection and prevention of fraud , waste, and abuse . Key Responsibilities: +...management Qualifications: + Minimum of 5 years of FWA, healthcare and/or Medicare Advantage experience + Strong knowledge of… more
- Molina Healthcare (Tampa, FL)
- …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... The position must have the ability to determine correct coding, documentation, potential fraud , abuse , and over utilization by providers and recipients. The… more
- MyFlorida (Miami, FL)
- …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... the administration of the Medicaid program and/or the alleged abuse or neglect of patients in healthcare ...experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired… more
- MyFlorida (Miami, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse , and waste. The Bureau of...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse , and waste. The Office of...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse , and waste. The Office of...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... This Medical Health Care Program Analyst position will support the fraud and abuse prevention efforts within the Bureau of Medicaid Program Integrity (MPI).… more