- The Cigna Group (Chicago, IL)
- We are looking for an experienced attorney skilled in compliance investigations to be part of the Legal Department's Enterprise Investigations unit. Our team of ... responsible for assessing and investigating reports and allegations of healthcare fraud (including False Claims Act, Anti-Kickback statutes, and Stark Law),… more
- Huntington National Bank (Chicago, IL)
- …Job Description Summary Internal Investigator will investigate suspected internal fraud /financial crimes and all reported occurrences of internal fraud ... financial transactions and related rules and statutes is key to success. Investigations require analysis of bank systems, very strong decision-making skills, and the… more
- Command Investigations (Chicago, IL)
- …a customer-centric approach, has allowed us to stand out as a leader in the investigation industry. At Command Investigations , we take pride in our proven track ... Command Investigations LLC is a dynamic and forward-thinking investigative...+ Minimum of 1 year experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Be able to hold… more
- Travelers Insurance Company (Downers Grove, IL)
- …determines whether or not a loss comes within the scope of the insurance contract. + Principles of Investigation : Intermediate investigative skills including the ... a settlement should be considered. **What Will You Do?** + Conduct investigations , including, but not limited to assessing policy coverage, contacting insureds,… more
- CVS Health (Springfield, IL)
- …seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role is ... Design, develop, and maintain complex data analyses to support investigations of potential fraud , waste, and abuse...data analytics or data science, preferably in healthcare, health insurance , or Medicaid programs + Ability to distill complex… more
- Travelers Insurance Company (Downers Grove, IL)
- …+ Insurance Contract Knowledge - Intermediate + Principles of Investigation - Intermediate + Value Determination - Intermediate + Settlement Techniques - ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, litigation management, negotiation and resolution) including… more
- Travelers Insurance Company (Springfield, IL)
- …- Advanced + Insurance Contract Knowledge - Advanced + Principles of Investigation - Advanced + Value Determination - Advanced + Settlement Techniques - Advanced ... handling throughout the claim life cycle (customer contacts, coverage, investigation , evaluation, reserving, litigation management, negotiation and resolution) including… more
- Synchrony (Chicago, IL)
- …and culture events. **Essential Responsibilities:** + Build and enhance credit risk and fraud risk models. + Drive development of in-house credit and transaction ... fraud models, particularly developing scorecard models + Utilize internal...to take a drug test, submit to a background investigation and submit fingerprints as part of the onboarding… more
- Prime Therapeutics (Springfield, IL)
- …is responsible for recovering inappropriate pharmacy payments related billing errors and fraud , waste and abuse (FWA) through various mechanisms, including but not ... are accurately processed in Prime's systems for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations … more
- Sedgwick (Springfield, IL)
- …plans to an appropriate and timely resolution. + Conducts or assigns full investigation , including coordination of field investigations and provides report of ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Surety Claims Advisor **PRIMARY PURPOSE** **:** To analyze complex or technically… more