- 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
- Donegal Insurance Group (Marietta, PA)
- …Qualifications and Skills + Bachelor's Degree + Minimum of 3 to 5 years of Insurance Fraud or Insurance related experience + Law enforcement investigation ... Company Overview Donegal Insurance Group is an insurance holding...reports + Assist in designated assignments related to Company anti- fraud initiatives + Establish and maintain professional working relationships… more
- Highmark Health (Harrisburg, PA)
- …**Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year ... :** **JOB SUMMARY** This job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training and filing of … more
- Highmark Health (Pittsburgh, PA)
- …Business or related field **EXPERIENCE** **Required** + 7 years of in the Health Insurance industry and/or Healthcare Fraud investigations + 3 years in leading ... graphs, and charts to timely identify trends and patterns of potential healthcare fraud , waste and abuse. Communicate findings to company management of various areas… 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 ... for clients.** **Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers and attorneys to develop demand for… 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 ... for clients.** **Collaborates with sales and operations managers, architects, developers, insurance adjusters, claims managers and attorneys to develop demand for… 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
- Boscov's Department Store, LLC (Laureldale, PA)
- Fraud Analyst (FT) We are looking for a...Short term disability/ Long term disability- voluntary + Life Insurance (company paid) + 401(k) w/ company match + ... hardworking and dependable individual to join our e-commerce fraud analysis team. The desired candidate should be very...They must have the ability to identify and prevent fraud to minimize loss for our company. Experience is… more