- Highmark Health (Columbus, OH)
- …+ Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge ... 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis… more
- Molina Healthcare (Columbus, OH)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- Elevance Health (Mason, OH)
- **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
- Elevance Health (Mason, OH)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... ** Investigator II** **Location Hybrid 1** : This role...claims. + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company… more
- Elevance Health (Columbus, OH)
- …independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client ... ** Investigator Senior** **Supports the Payment Integrity line of...+ Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than… more
- US Bank (Cincinnati, OH)
- …adhered to during case investigations + Serve as a resource for Investigator and Reviewer questions or issues regarding feedback **Basic Qualifications** + ... include the following (some may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional term life insurance +… more
- CVS Health (Columbus, OH)
- … conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge and… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- Otsuka Pharmaceutical Company is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." Otsuka ... clinical pharmacology documents for regulatory filings including annual reports, investigator 's brochure, IND/NDA applications and pediatrics development plans. +… more