- MVP Health Care (Rochester, NY)
- …to MD or RN. + New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or ... At MVP Health Care, we're on a mission to create...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more
- Highmark Health (Pittsburgh, PA)
- …or related field **EXPERIENCE** **Required** + 7 years of in the Health Insurance industry and/or Healthcare Fraud investigations + 3 years in leading ... be called upon as a subject matter expert for investigations providing guidance and mentoring to investigative team. Must...in Financial Analysis in an acute care hospital or health insurance setting + 5 years in… more
- NTT DATA North America (Boston, MA)
- …obtain additional information about assigned reviews Qualifications: 1-3 year's related experience in health insurance fraud investigations , health ... strategy. NTT DATA's Client is seeking a Investigator for Health Plan Special Investigations Unit ( "SIU... Examiner (CFE), Certified Professional Coder (CPC), or Accredited Health Care Fraud Investigator (AHFI) preferred Familiarity… more
- Highmark Health (Atlanta, GA)
- …**Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year ... fraud , waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to...in Financial Analysis in an acute care hospital or health insurance setting + 1 year in… more
- BlueCross BlueShield of North Carolina (NC)
- …Special Investigations Unit (SIU) Investigator is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company. ... $62,100.00 - $111,800.00 **Skills** Depositions, Evidence Collection, Forensic Accounting, Fraud Investigations , Investigation Techniques, Investigative Analysis, Job… more
- Guidehouse (Richardson, TX)
- …gain employment with our rapidly growing firm. Guidehouse is seeking experienced Fraud Investigations Analyst's to conduct, identify, and investigate potential ... document and escalate such matters. The responsibilities of the Fraud Investigations Analyst will include, but are...workplace. Benefits include: + Medical, Rx, Dental & Vision Insurance + Personal and Family Sick Time & Company… more
- MyFlorida (Tallahassee, FL)
- HEALTH INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our ... . Requisition No: 859230 Agency: Management Services Working Title: HEALTH INSURANCE FRAUD ANALYST II...data analytics to proactively identify qualified leads for potential fraud , waste, and abuse (FWA) investigations . The… more
- State of Colorado (Denver, CO)
- …Office about those complaints. While your primary responsibility will be managing our fraud filing complaint investigations and processes, you will also have the ... and businesses affected by fraudulent business filings. In addition to managing our fraud filing complaint investigations , you will also be responsible for other… more
- State of Colorado (Denver, CO)
- …but primarily though the online Medicaid complaint portal. The position conducts investigations of Medicaid Fraud , Abuse, and Neglect complaints, analyzes intake ... Colorado benefits package (https://stateofcoloradobenefits.com/) including competitive medical and dental health plans, employer-paid life insurance , paid holidays,… more
- New York State Civil Service (New York, NY)
- …and support personnel, tasked with analyzing and assessing financial and insurance fraud referrals;* Manages an Assistant Chief Investigator supervising ... and trends to help set investigative direction and focus;* Manages financial and insurance fraud referral intake procedures for thoroughness and timeliness, and… more