- Louisville/Jefferson County MSD (Louisville, KY)
- Safety & Security Investigator Print (https://www.governmentjobs.com/careers/louisvillemsd/jobs/newprint/5009262) Apply Safety & Security Investigator Salary ... employees and contractors. Assists in investigating fraudulent Workers' Compensation claims by conducting surveillance. Utilizes GPS data by obtaining data… more
- CVS Health (Carson City, NV)
- …it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- University of Rochester (Rochester, NY)
- …the University community and meet the University's legal obligations to address claims of hostile work environment, discrimination, harassment or other kinds of ... for each case, whether identified by the parties, witnesses or at the investigator 's discretion + Completes all investigations in a timely fashion based on scope,… more
- University of Washington (Seattle, WA)
- …and offers guidance on legal and regulatory matters, risk financing and claims , and supports institution-wide initiatives related to safety, civil rights, Title IX, ... Reporting to the Manager of Civil Rights Investigations, the ** Investigator ** will focus on a wide range of complex...VII, Title VI, the ADA, and related laws, university systems , and campus partnerships. You will join a supportive… more
- CVS Health (Hartford, CT)
- …every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In this role, ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
- Highmark Health (Dover, DE)
- … (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have ... understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed oriented… more
- US Secret Service (Washington, DC)
- …the United States and overseas. Certify that you have registered with the Selective Service System or are exempt from having to do so, if you are a male applicant ... undergraduate course work (credit hours) were taken on a pass/fail or similar basis, your claim must be based on class standing or membership in an honor society. At… more
- CVS Health (Annapolis, MD)
- …healthcare fraud cases. - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, customer members, etc. - Facilitates ... clinical and legal review. - Documents all appropriate case activity in tracking system . - Makes referrals and deconflictions, both internal and external, in the… more
- V2X (Phoenix, AZ)
- …well as performing thorough vehicle inspections, research of the vehicle history, insurance claims , and / or repairs, etc. The ideal candidate will have Dealership ... + Maintain knowledge of customer's vehicle product lines and systems + Hands-on vehicle expertise and knowledge in an...Electronics or T1 - T8 + Knowledge of automotive systems and repair procedures + Knowledge of diagnostic test… more
- Mount Sinai Health System (New York, NY)
- …schedule that is assigned. + Prepares all downloads of billing files from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House ... preferred) + Edits unbilled/unprocessed accounts (billing) using PFS HIS Systems , Clearing House Claim Scrubber and/or any...Claim Scrubber and/or any payer websites available for claim correction of billed accounts. + Bill claims… more
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