- CVS Health (Atlanta, GA)
- …investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state ... regulations mandating fraud plans and practices. - Conducts investigations of known...Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and… more
- Molina Healthcare (Covington, KY)
- …position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position ... tools, or strategy. + Effectively investigate and manage complex and non-complex fraud allegations. + Develop and maintain relationships with key business units… more
- Centene Corporation (Columbus, OH)
- …NE, and OH.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims ... or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste,...abuse. + Conduct investigations of potential waste, abuse, and fraud + Document activity on each case and refer… more
- Elevance Health (St. Louis, MO)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... Candidate Must Reside in Missouri + Healthcare experience strongly preferred + Fraud certification from CFE, AHFI, AAPC or coding certificates preferred + Knowledge… more
- Marriott (Bethesda, MD)
- …Required 3 years of experience in customer service, operations, risk management, fraud mitigation or related field BS/BA in accounting, finance, or related field ... preferred. CORE WORK ACTIVITIES + Timely independent investigation and resolution of reported fraud and abuse incidents. + Research to understand use case issue and… more
- State of Arkansas (Little Rock, AR)
- …data analysis, and strategic problem-solving. Specialized certifications (eg, Certified Fraud Examiner, Certified Forensic Investigator ) may be required. ... detailed investigations into internal, regulatory, and external issues-ranging from fraud and misconduct to compliance violations and process irregularities. This… more
- Sysco (Houston, TX)
- …2 years in Audit or Investigations **Licenses/Certification Preferred:** CFE (Certified Fraud Examiner), CFI (Certified Forensic Investigator ), and/or CISA ... success working in a large, complex, multi-national company. + CFE (Certified Fraud Examiner), CFI (Certified Forensic Investigator ), and/or CISA (Certified… more
- Capital One (Richmond, VA)
- AML Supervisor, Transaction Monitoring Operations, Fraud **Job Description** The Anti-Money Laundering (AML) Supervisor supervises various AML processes, which might ... activities as well as managing the workflow of the AML analysis. The AML Investigator II coaches their team and teaches others about AML processes through training… more
- FlexStaff (Lake Success, NY)
- …practices, policies, and regulations. + Meets requirements for obtaining Certified Fraud Examiner (CFE) and/or Certified Financial Crimes Investigator (CFCI) ... **Req Number** 174825 Fraud Specialist M-F, full time Bethpage, NY (hybrid)...NY (hybrid) Temp (4-6 months) FlexStaff is seeking a Fraud Specialist for our client, a full-service banking institution,… more
- State of Georgia (Fulton County, GA)
- Intake Coordinator- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72587/other-jobs-matching/location-only) Hot ... Job Sign Up for Job Alerts Office of the Attorney GeneralDepartment of LawMedicaid Fraud - Intake Coordinator Salary - $40,000.00 The mission of the Department of… more