- Sanford Health (Fargo, ND)
- …insurance investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) ... package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies. Respond to subpoenas and requests for… more
- Zelis (Boston, MA)
- … Fraud in prevention, detection, reporting, and monetary recovery related to financial fraud and healthcare fraud , waste, and abuse. What You'll Do ... it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare...interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute… more
- Humana (Oklahoma City, OK)
- …**Required Qualifications** + **Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... 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
- New York State Civil Service (New York, NY)
- …detectives, data analysts, and legal support analysts, to conduct complex, long-term healthcare fraud and patient abuse and neglect investigations. The Medicaid ... Agency Attorney General, Office of the Title Medical Analyst: Legal Nurse, Fraud /Patient Abuse (6413) Occupational Category Legal Salary Grade NS Bargaining Unit M/C… more
- New York State Civil Service (New York, NY)
- …data analysts, nurses, and legal support analysts to conduct complex, long-term healthcare fraud investigations.The Medicaid program provides health coverage to ... General, Office of the Title Forensic Auditor: Investigate Complex Medicaid Fraud (6414) Occupational Category Financial, Accounting, Auditing Salary Grade NS… more
- State of Georgia (Fulton County, GA)
- …or more items below: + Attorneys with civil litigation experience, with an emphasis on healthcare or fraud matters. + Demonstrated ability to work in a team is ... Assistant Attorney General 1 - Medicaid Fraud -Civil Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72524/other-jobs-matching/location-only)… more
- LA Care Health Plan (Los Angeles, CA)
- …or Related Field Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations, law enforcement, or related field. At least ... Preferred And/Or any of the following Licenses/ Certifications: Certified Fraud Examiner (CFE) Certified HealthCare Compliance (CHC) Certified… more
- Molina Healthcare (Covington, KY)
- …insurance company + Minimum of two (2) years' experience working on healthcare fraud related investigations/reviews + Proven investigatory skill; ability to ... Certification, Association + Valid driver's license required. **Preferred Experience** + Healthcare Anti- Fraud Associate (HCAFA), Accredited Health Care Fraud… more
- Zelis (Somo, WI)
- …prevention, investigations, or risk management - preferably in payments, fintech, or healthcare . + Proven expertise in fraud detection tools, behavioral ... So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more… more
- CVS Health (Richmond, VA)
- …you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high ... involving multi-lines of business, or cases involving multiple perpetrators or intricate healthcare fraud schemes. + Investigates to prevent payment of… more