- Providence (Oakland, CA)
- …education related to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan staff, vendors and contracted ... provider, facility or health insurance company. + 2 years Fraud and Abuse audit experience in a health insurance...your family in staying well, growing professionally and achieving financial security. We take care of you, so you… more
- NTT DATA North America (Atlanta, GA)
- …the **payment's domain** (merchant onboarding, transactions, clearing, settlement, funding, fraud /risk, reporting). + Develop **ETL/ELT pipelines** to integrate data ... **real-time and batch data integration** for use cases such as ** fraud detection, reconciliations, settlement reporting, and regulatory compliance** . + Monitor… more
- NTT DATA North America (Atlanta, GA)
- …the payment's domain (merchant onboarding, transactions, clearing, settlement, funding, fraud /risk, reporting). Develop ETL/ELT pipelines to integrate data from core ... real-time and batch data integration for use cases such as fraud detection, reconciliations, settlement reporting, and regulatory compliance. Monitor and tune… more
- Wells Fargo (Iselin, NJ)
- …for these groups to support modernization and optimization. Within TCOO, the Fraud and Claims Technology team is seeking a Senior Infrastructure Engineer to ... help drive the evolution of our Fraud Analytics and Intelligence Platform. This platform underpins real-time AI model execution that protects millions of customers… more
- Elevance Health (Mason, OH)
- …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an Impact:** + Examines claims for ... compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and conducts analysis… more
- DataVisor (Mountain View, CA)
- …$10M+ ARR and driving significant upsell revenue. + Deep understanding of the Fraud /Regtech solutions landscape and the financial services industry. + Strong ... About DataVisor DataVisor is the world's leading AI-powered Fraud and Risk Platform that delivers the best...scales infinitely and enables organizations to act on fast-evolving fraud and money laundering activities in real time. Its… more
- University of Rochester (Brighton, NY)
- …assisted living communities. This includes, but is not limited to fraud and abuse, billing compliance, corporate transactions, physician employment and compensation, ... for Health Sciences, researches, analyzes, and provides regulatory compliance advice on the Fraud and Abuse + Laws, including, but not limited to, the Anti-Kickback… more
- Capgemini (Berkeley Heights, NJ)
- …lead the strategy, roadmap, and execution of solutions within the Check Fraud and Positive Pay space. This includes collaborating with cross-functional teams, ... + Managing the full product lifecycle + Collaborating with engineering, fraud ops, and business stakeholders + Driving strategy across Treasury, Commercial… more
- Option Care Health (Bannockburn, IL)
- …risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse. + Perform data analysis and review of documentation to identify ... compliance requirements related to billing and coding, privacy and security, and fraud , waste and abuse, including but not limited to HIPAA, Anti-Kickback, Stark,… more
- FirstBank PR (San Juan, PR)
- …industry trends and customer behavior. Identify opportunities for payment innovation and fraud prevention. + . Promote innovation through new tech solutions. Improve ... and monitor KPIs and dashboards related to payment volumes, exceptions, reconciliation, and fraud metrics. + . Identify and lead resolution of risks related to… more