- Highmark Health (Pittsburgh, PA)
- …documentation requirements, state and federal criminal and civil law related to insurance fraud and advances in the post-payment utilization review process ... strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment of related...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more
- AmeriHealth Caritas (Newtown Square, PA)
- …+ Credentials such as Certified Fraud Examiner, Accredited Healthcare Fraud Investigator, Certified Insurance Fraud Investigator, Certified Internal ... will lead efforts to detect, investigate and prevent healthcare fraud within the pharmacy operations. ; This role combines...Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day… more
- Ally (Harrisburg, PA)
- …evolving, so shouldn't your opportunities be, too? **The Opportunity** The Debit Card Fraud Program Leader is responsible for driving the strategy for fraud ... Ally adheres to key regulations and industry best practices while optimizing fraud detection capabilities and recoveries. The leader will also develop and maintain… more
- Ally (Harrisburg, PA)
- …so shouldn't your opportunities be, too? **The Opportunity** The Director of Fraud Training - Consumer Bank is responsible for leading training efforts related ... to fraud prevention, detection, and resolution within the Deposits and...* Supporting your Health & Well-being: flexible health and insurance options including dental and vision, pre-tax Health Savings… more
- Ally (Harrisburg, PA)
- …be, too? **The Opportunity** Ally is seeking a highly skilled and experienced Fraud Strategy Director to join our Fraud Prevention team. The successful ... responsible for supporting strategic initiatives that originate outside of the fraud organization, however, will also have responsibility of supporting Fraud… more
- TEKsystems (Pittsburgh, PA)
- …Onsite in Downtown Pittsburgh, PA or Birmingham, AL Description Fraud Support: consume inbound/outbound communications through ticket creation/management, providing ... such fraud support 24x7x365. The Fraud Support team...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Guardian Life (Bethlehem, PA)
- …+ Ability to spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and manual exception reports and ... but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business...million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to… more
- EFI Global (Harrisburg, PA)
- …the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a ... to, medical, dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health savings account, and other… more
- PNC (Pittsburgh, PA)
- …be performed remotely, at manager's discretion. Responsibilities Demonstrated knowledge of Fraud related risks and a solid business understanding of application of ... key business segments including retail, banking, capital markets, etc. Plan, perform, and lead Fraud audits at the enterprise level as well as other diverse lines of… more
- Humana (Harrisburg, PA)
- …investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced ... + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years...Medicare experience + Minimum 3 years of experience with Fraud , Waste, and Abuse in a Managed Care setting… more