- Elevance Health (St. Louis, MO)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... more than one company health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and… more
- Command Investigations (Syracuse, NY)
- …the frontline of the private investigations industry. The primary responsibility of the Investigator is to conduct mobile surveillance of an individual that has an ... on-going insurance claim . Surveillance is conducted in order to document (on...MUST be 18 years of age or older (21+ preferred ). + MUST have a registered and insured vehicle… more
- CVS Health (Columbus, OH)
- …it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts ... or intricate healthcare fraud schemes. + Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares… more
- Highmark Health (Pittsburgh, PA)
- …6 years of related and progressive experience in lieu of Bachelor's degree ** Preferred ** + Master's Degree in Fraud, Forensics Accounting, Business or related field ... progressive experience in the health insurance industry and/or healthcare fraud investigations ** Preferred ** + 1 year in Financial Analysis in an acute care hospital… more
- CVS Health (Topeka, KS)
- …States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Research and… more
- Marshfield Clinic (Marshfield, WI)
- …Experience Required: Two years previous work experience in collections, legal, claims processing, or subrogation related field. Preferred /Optional Experience: ... most exciting missions in the world!** **Job Title:** Subrogation Investigator **Cost Center:** 682891012 SHP-Legal-Subrogation **Scheduled Weekly Hours:** 40… more
- Allied Universal (Portland, OR)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim … more
- The Robison Group (Brooklyn, NY)
- …such as auto and property theft, fire damages, auto accidents, commercial claims , finding missing persons, courthouse searches, and other investigative tasks. For ... for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator , you will be joining an incredible team of investigators and industry… more
- Molina Healthcare (Covington, KY)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems +… more
- Allied Universal (Reno, NV)
- …**Minimum Requirements:** + Applicants must be at least 21 years of age. + A private investigator license is preferred . + Be at least 18 years of age for unarmed ... As a Part-Time Security Officer, you'll use our exclusive Claim a Shift platform to view and Pick up...Tools:** Access to our exclusive technology to view and claim additional shifts to earn more. + **Career Growth:**… more