- CVS Health (Columbus, OH)
- …communication skills + Advanced experience in Excel **Preferred Qualifications** + Experience in healthcare fraud , waste and abuse + Knowledge of Medicaid ... skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud... healthcare data into actionable insights to support fraud , waste, and abuse (FWA) detection and Medicaid regulatory… more
- Molina Healthcare (Ann Arbor, MI)
- …The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... of experience working in a FWA / SIU or Fraud investigations + Thorough knowledge of PC based software...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… 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
- CVS Health (San Antonio, TX)
- …a team of investigators to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... the team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and providers. Provides direction and counsel on… more
- MyFlorida (Miami, FL)
- …or education requirements of s. 943.135. Preference will be given to candidates with healthcare fraud investigative experience working in a Medicaid Fraud ... enforcement experience, or five (5) years of work experience conducting healthcare fraud investigations. Note: All newly hired employees must obtain CJSTC Sworn… more
- CVS Health (St. Paul, MN)
- …- Conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... and practices. - Conducts investigations of known or suspected acts of healthcare fraud and abuse. - Communicates with federal, state, and local law enforcement… more
- Highmark Health (Pittsburgh, PA)
- …3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis ... Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider… more
- CVS Health (Topeka, KS)
- …in the United States. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- Idaho Division of Human Resources (Boise, ID)
- …at least 5 years of investigative experience, preferably in law enforcement, healthcare fraud or financial crimes. Strong analytical; interviewing, and ... minimum of 5 years of investigative experience, preferably in Medicaid or healthcare fraud , financial crimes or white-collar investigations. + Experience… more