- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position… more
- State of Georgia (GA)
- Criminal Investigator 1 - Calhoun SP in Morgan Ga. Georgia (https://ga.referrals.selectminds.com/jobs/74265/other-jobs-matching/location-only) Hot ... (https://ga.referrals.selectminds.com/landingpages/law-enforcement-opportunities-at-team-georgia-3) Law Enforcement Corrections, Georgia Department of - GDC Nov 18, 2025 Post Date Apply for Job Share this Job Sign Up for Job Alerts Preferred Qualifications:… more
- CVS Health (Atlanta, GA)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... specific self-funded plan sponsor. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud, waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex investigations of known or suspected acts… more
- Command Investigations (Atlanta, GA)
- …Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or ... Homeowners Investigations. + Writing accurate, detailed reports + Strong initiative, integrity, and work ethic + Securing written/recorded statements + Accident scene investigations + Possession of a valid driver's license + Ability to prioritize and organize… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …our academic community. **Description** As Intelligence and Threat Assessment Investigator , has responsibility for identifying, assessing, and managing potential ... threats to the safety and security of the Emory enterprise. KEY RESPONSIBILITIES: + Conducts comprehensive investigations into concerning behaviors, threat reports, and incidents involving students, faculty, staff, and visitors. + Collaborates closely with the… more
- Molina Healthcare (Atlanta, GA)
- …**Job Summary** Under direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on daily ... investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the life of an investigation as well as QA reviews and… more
- Manulife (GA)
- …: + Successfully completes high-quality, sophisticated long term care claims investigations + Independently develops and drives a detailed investigative plan + ... Acquires and reviews internal / external documents to support investigative activity and findings + Conducts interviews of insureds, caregivers, and other involved parties + Handles third party vendor(s) conducting long term care surveillance activities +… more
- Humana (Atlanta, GA)
- …+ Bachelor's degree or equivalent work experience + Strong clinical experience to include multiple practice areas + At least 2 years of healthcare fraud ... investigations and auditing experience + Knowledge of healthcare payment methodologies + Strong organizational, interpersonal, and communication skills + Inquisitive nature with ability to analyze data to metrics + Computer literate (MS, Word, Excel, Access) +… more
- Parexel (Atlanta, GA)
- **Key Accountabilities:** **Contracting deliverables** + Exercise good judgment in balancing the risks to the client in making budget and contractual decisions ... against the impacts to client clinical trial timelines + Follow client processes to develop, negotiate, track and execute global clinical study agreements with institutions and investigators participating in sponsored clinical trials + Work with partners to… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …The Emory University School of Medicine and the Emory Winship Cancer Institute in Atlanta, Georgia, seeks a board-certified Medical Oncologist with interest and ... experience in Lung/Thoracic Cancers. Academic interests could include translational research, early phase clinical trials, symptom management, observational studies, and/or health disparities. The ideal candidate will provide direct patient care and support… more