- Travelers Insurance Company (Morristown, NJ)
- …evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. + Verifies the nature and extent of injury ... to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements.… more
- NJM Insurance (Trenton, NJ)
- …of timely, appropriate, and accurate benefits + Evaluate the claim for potential fraud indicators and escalate the claim to SIU, as appropriate + Recognize and ... Preferred: + Associate or bachelor's degree + AIC/CPCU or other applicable insurance designations + Experience using Guidewire Claim Center, OnBase and additional… more
- NJM Insurance (Trenton, NJ)
- …and presenting a business question to our top leaders. + Leader Presentations: Insurance Industry, Key Departments and how they work and more. + Informational ... Unit, (SIU). Interns for the summer season will assist the SIU in anti- fraud efforts by conducting data analysis, intelligence gathering, and leveraging internal and… more
- Travelers Insurance Company (Morristown, NJ)
- …such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts. + Verify the nature and extent of injury ... + Communication - Advanced + Negotiation - Advanced + Insurance Contract Knowledge - Advanced + Principles of Investigation...job. **What Is in It for You?** + **Health Insurance ** : Employees and their eligible family members -… more
- Travelers Insurance Company (Trenton, NJ)
- …evaluate claims, such as Subro, Risk Control, nurse consultants and fire or fraud investigators and other experts. + Verify the nature and extent of injury ... job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state...job. **What Is in It for You?** + **Health Insurance ** : Employees and their eligible family members -… more
- NJM Insurance (Trenton, NJ)
- …and assist GC Legal in reviewing the NJM Special Investigations Unit (SIU) fraud investigations. + Prepare annual review of outside counsel using data provided from ... up to 8% and additional service-based contributions, Health, Dental, and Vision insurance , Life and Disability coverage, generous PTO, Paid Sick Leave, and paid… more
- CVS Health (Trenton, NJ)
- …United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- Highmark Health (Trenton, NJ)
- …Analytics will work closely with Senior Data Scientists to support Highmark's Fraud , Waste, and Abuse identification efforts. Daily responsibilities will involve the ... the business. - Collaborate with senior team members on Fraud , Waste, and Abuse identification initiatives to develop and...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more
- Stryker (Mahwah, NJ)
- …and marketing of medical devices/technologies including matters related to anti-trust, fraud and abuse, HIPAA, and anti-kickback (including applicable safe harbors) ... + 3+ years applicable experience required **Preferred** + 2+ fraud and abuse, anti-kickback experience is highly desirable +...3 days. Health benefits include: Medical and prescription drug insurance , dental insurance , vision insurance ,… more
- Fiserv (Berkeley Heights, NJ)
- …as card production, fulfillment, call center performance, dispute resolution, fraud monitoring, and compliance adherence-run seamlessly in a steady-state ... experience. + Support processing of Reg E disputes and fraud alerts within defined SLAs. + Maintain accurate logs...Purchase Plan. + Medical, dental, vision, life, and disability insurance options available day one + Tuition assistance and… more