- State of Georgia (Fulton County, GA)
- …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary knowledge… more
- State of Colorado (Denver, CO)
- … Examiner; + Experience/training as a FTO or as a LE instructor; + Participation with health care fraud or elder abuse task forces or committees; + ... Medicaid Fraud Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057010) Apply...protect the state and federal funds dedicated to providing health care and medical services to Colorado… more
- BlueCross BlueShield of North Carolina (NC)
- …The Special Investigations Unit (SIU) Investigator is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company. ... to case closure + Prepares and conducts presentations and/or provides content for health care fraud and abuse education and awareness **What You'll Bring** +… more
- CVS Health (Harrisburg, PA)
- …of fraud and abuse **Required Qualifications** 1 year experience working on health care fraud , waste, and abuse investigatory and audits required. ... arbitrations, depositions, etc. **Preferred Qualifications** 1-3 years experience working on health care fraud , waste, and abuse investigations and audits… more
- Highmark Health (Pittsburgh, PA)
- …of legal and investigative procedures used in the detection and successful resolution of health care fraud , waste and abuse (FWA) cases **Language (Other ... strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment of related...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- Corewell Health (Grand Rapids, MI)
- …investigation of fraud and abuse within Priority Health . Utilizes knowledge/expertise of health care fraud to investigate all types of health ... group, agent or other fraudulent entity. + 2 years of relevant experience Related health care experience One of the following certifications is required: +… more
- State of Minnesota (St. Paul, MN)
- …health benefits administration setting. Experience must demonstrate: + Direct involvement in health care fraud , waste, and abuse (FWA) investigations, ... Investigations Units (SIUs) to prevent, detect, and respond to fraud , waste, abuse, and noncompliance that may result in...Managed Care plans. + Understanding of Minnesota Health Care Programs (MHCP), especially Medical Assistance… more
- Molina Healthcare (Lexington, KY)
- …prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include ... Services, Claims) to gather documentation pertinent to investigations. + Detects potential health care fraud , waste, and abuse through the identification of… more
- Executive Office for US Attorneys and the Office of the US… (Atlanta, GA)
- …securities fraud , computer intrusion and hacking, government program fraud , identity theft, health care fraud , bank fraud , immigration fraud , ... seeks recovery of government funds fraudulently obtained, litigates affirmative civil fraud and enforcement actions, and defends the US Government's interest in… more
- MyFlorida (Tallahassee, FL)
- …to the prevention, detection, or investigation of fraud , waste or abuse in health care or experience in auditing, data analysis, or fraud detection. ... HEALTH INSURANCE FRAUD ANALYST II -... HEALTH INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19,...and other sources by applying your knowledge of heath care coding conventions, fraud schemes, general areas… more