- CVS Health (Atlanta, GA)
- …conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse , to recover lost funds, ... state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge… more
- CVS Health (Atlanta, GA)
- …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
- Elevance Health (Atlanta, GA)
- …preferred. + Marketing experience preferred. + Medicare Part D experience preferred. + Fraud waste and abuse experience preferred. For candidates working in ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
- State of Georgia (Fulton County, GA)
- …limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary knowledge and skills ... to assignments and requests for assistance in health care fraud and patient abuse investigations in a...Healthcare Administration, Accounting, Business and Finance. * Certified Fraud Examiner * Digital Forensics Experience * Law enforcement… more
- Elevance Health (Atlanta, GA)
- …Coding Certificate or Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance Health only accepts ... and/or entities that may pose potential risk associated with fraud and abuse . **How you will make...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- Highmark Health (Atlanta, GA)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of… more
- Molina Healthcare (Atlanta, GA)
- …SIU an active relationship with third parties who have specific experience in conducting fraud and abuse investigations. * Prepares written reports to inform the ... Enforces, as a representative of management, the Compliance Plan, Code of Conduct and Anti- Fraud Plan. * Establishes, at the direction of the AVP of Compliance or… more
- Prime Therapeutics (Atlanta, GA)
- …**Job Description** Responsible for the intake and initial handling of allegations of fraud , waste or abuse . Conducts preliminary investigation to assess the ... audit or investigation. Serves as a corporate resource on fraud , waste and abuse issues and maintains...to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general… more
- Molina Healthcare (Augusta, GA)
- …standards and requirements contained in the Molina Medical Compliance and Fraud , Waste and Abuse Program. **KNOWLEDGE/SKILLS/ABILITIES** + Coordinates, conducts, ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Macon, GA)
- …day-to-day operations of the Compliance Program, Compliance Plan, Code of Conduct, and Fraud , Waste and Abuse Plan across the enterprise while ensuring ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
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