- Humana (Dayton, OH)
- …community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring ... outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program integrity … more
- MyFlorida (Doral, FL)
- INVESTIGATOR SPECIALIST II - 79001458 Date: Dec 5, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 865093 Agency: Business and Professional Regulations Working Title: INVESTIGATOR SPECIALIST II - 79001458 Pay Plan: Career Service Position Number:… more
- Idaho Division of Human Resources (Lewiston, ID)
- Senior Agricultural Investigator - Lewiston or Post Falls Posting Begin Date: 2025/09/09 Posting End Date: 2025/12/11 Category: Agriculture Sub Category: Natural ... The Idaho Department of Agriculture is currently recruiting for an Agriculture Investigator Senior in the division of Agriculture Resources located in Lewiston or… more
- Point32Health (Canton, MA)
- …about who we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Investigator I is an essential team member of the Special Investigation Unit ... ("FWA") investigations under the direction of the Manager, FWA Prepayment Review. The Investigator I works closely with other members of the SIU to set investigative… more
- Elevance Health (St. Louis, MO)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible...company health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review,… 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)
- **Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!** **Job Title:** Subrogation Investigator ... Required: Two years previous work experience in collections, legal, claims processing, or subrogation related field. Preferred/Optional Experience: Qualified… more
- Highmark Health (Pittsburgh, PA)
- …or alleged fraud/waste and abuse cases or special projects. + Provides advisory support as needed to internal and external law enforcement and regulatory agencies, ... Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment… more
- City and County of San Francisco (San Francisco, CA)
- …and submission of claims to the California Victim Compensation and Government Claims Board, and monitor claim progress and payment. 5. Assist with the ... the criminal justice system humane and accessible by providing support and assistance to victims and their families in...losses when possible, and, in general, works tirelessly to support victims regain control over their lives. The Victim… more
- The Boeing Company (Ridley Park, PA)
- …NTSB, the FAA, and other foreign and domestic government agencies + Support the identification and mitigation of airplane related risks (design, maintenance, ... processes and initiatives. + Participates in the discussion of legal cases and claims with in-house and outside counsel. + Researches, acquires and provides specific… more