- Elevance Health (Richmond, VA)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying… more
- Elevance Health (Norfolk, VA)
- ** Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... employment, unless an accommodation is granted as required by law. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Sanford Health (Fargo, ND)
- …Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred Nursing or other clinical experience highly preferred ... health insurance investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud … more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Clinical Investigator ** to join #TeamMVP. This is the opportunity for you ... professional investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
- NTT DATA North America (Boston, MA)
- … Examiner (CFE), Certified Professional Coder (CPC), or Accredited Health Care Fraud Investigator (AHFI) preferred Familiarity with Partial Hospitalization and ... as part of an overall sourcing strategy. NTT DATA's Client is seeking a Investigator for Health Plan Special Investigations Unit ( "SIU ) REMOTE EAST COAST The… more
- CVS Health (Charleston, WV)
- …every day. **Position Summary** **WEST VIRGINIA RESIDENCY** **REQUIRED** As a Senior Investigator you will conduct high level, complex investigations of known or ... suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive...lines of business + Researches and prepares cases for clinical and legal review + Documents all appropriate case… more
- State of Georgia (Fulton County, GA)
- …Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the recruiting process ... Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot...will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the direction of the… more
- Lane County (OR)
- Investigator Print (https://www.governmentjobs.com/careers/lanecountyor/jobs/newprint/5068942) Apply Investigator Salary $85,176.00 - $116,584.00 Annually ... the Position As an integral member of our public safety team, the Investigator will support Deputy District Attorneys across Criminal, Family Law (Child Support… more
- CVS Health (Harrisburg, PA)
- …each and every day. **Position Summary** **Position Summary** TThe SIU Investigator conducts investigations to effectively pursue the prevention, investigation and ... prosecution of healthcare fraud and abuse, to recover lost funds, and to...providers, claimants, etc. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case… more
- CVS Health (Hartford, CT)
- …to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse. Also reports suspected fraud , waste, and ... Conducts investigations of known or suspected acts of healthcare fraud , waste, and abuse - Communicates with federal, state,...waste, and abuse - Researches and prepares cases for clinical and legal review - Documents all appropriate case… more