- Humana (Oklahoma City, OK)
- …into allegations of fraud , waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud ... help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team of… more
- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud ...hours are Monday-Friday, 8 hours/day, 5 days/week in the associate 's home time zone. **Required Qualifications** * Bachelor's Degree… more
- Humana (Oklahoma City, OK)
- …us put health first** Humana Healthy Horizons in Oklahoma is seeking a Fraud and Waste Professional 2 who conducts investigations of allegations of fraudulent and ... abusive practices. The Fraud and Waste Professional 2 work assignments are varied...CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in… more
- Humana (Juneau, AK)
- …investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced ... reports. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross… more
- First Horizon Bank (Knoxville, TN)
- …trusted point of contact for First Horizon clients navigating credit and debit card fraud or dispute claims , ensuring a seamless and supportive experience. + ... location listed in job posting. At First Horizon Bank Operations , we are on a mission to deliver a...feedback to improve processes and enhance both client and associate experiences. Core Competencies and Values Alignment: + Demonstrated… more
- Zurich NA (Topeka, KS)
- …and/or Illinois. This multi-state experience is essential to effectively support our regional claims operations and drive strong outcomes. In this position you ... Litigated Claims Specialist, Workers Compensation 125897 At Zurich North...internal control requirements. + Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud… more
- NJM Insurance (Trenton, NJ)
- …being a key component in the growth and success of our policyholders' business operations . To meet these expectations, WC Claims Specialists are supported by a ... NJM is seeking a Workers' Compensation (WC) Claims Specialist (I/II/Sr.) . This is a full-time...and accurate benefits + Evaluate the claim for potential fraud indicators and escalates the file to SIU, as… more
- Raymond James Financial, Inc. (Pittsburgh, PA)
- **Summary of the Position:** The Senior Wire Operations Associate will deliver high quality customer service and perform daily processing of financial ... time sensitive operations environment. The Senior Wire Operations Associate will conduct all aspects of...fraud + Investigates and researches suspicious or fraudulent claims in accordance with the Bank's policy and procedures… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- **Job Summary** The Associate Director of Commercial Data Science, CNS, will play a pivotal role in driving data-driven decision making to enhance marketing strategy ... and brand performance. The Associate Director will work closely with cross-functional teams, including Marketing, Commercial Operations and Market Access, to… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …manage all aspects of the commercial strategic sourcing and procurement services operations . The Associate Director of Commercial Strategic Sourcing has overall ... **Job Description** The Associate Director of Commercial Strategic Sourcing will lead...business stakeholders. + Partners with Business Owners and Financial Operations , and other key process owners to ensure Sourcing… more