- Elevance Health (Norfolk, VA)
- …Coding Certificate or Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance Health only accepts ... and/or entities that may pose potential risk associated with fraud and abuse . **How you will make...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- DoorDash (San Francisco, CA)
- …DoorDash's platform by building scalable systems that detect and prevent fraud , account takeovers, and identity abuse -without compromising user experience. ... is more important than ever. That's why we're investing in industry-leading fraud defenses to ensure a safe, seamless experience for every customer, Dasher,… more
- New York State Civil Service (New York, NY)
- …the unit's New York City office. The selected attorney will lead complex civil fraud investigations in the healthcare industry, as well as litigate such matters ... Agency Attorney General, Office of the Title Attorney: Lead Complex Civil Fraud Investigations (3788) Occupational Category Legal Salary Grade NS Bargaining Unit M/C… more
- Humana (Juneau, AK)
- …3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud , Waste, and Abuse in a Managed Care setting + Minimum 3 years of ... investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced… more
- Danaher Corporation (Austin, TX)
- …would be a plus if you also possess previous experience in: + Experience with healthcare regulation, including: fraud and abuse (eg, anti-kickback); FDA for ... we've been dedicated to advancing and optimizing the laboratory to move science and healthcare forward. Join a team where you can be heard, be supported, and always… more
- Danaher Corporation (Brea, CA)
- …would be a plus if you also possess previous experience in: + Experience with healthcare regulation, including: fraud and abuse (eg, anti-kickback); FDA for ... we've been dedicated to advancing and optimizing the laboratory to move science and healthcare forward. Join a team where you can be heard, be supported, and always… more
- Atlantic Health System (Morristown, NJ)
- …Medicare and Medicaid, and federal and state healthcare regulatory issues, including fraud and abuse , the Stark Law, the Anti - Kickback Statute, ... monitoring of regulatory developments, and legal research on regulatory issues, including fraud and abuse issues, HIPAA compliance, EMTALA, Medicare and Medicaid… more
- Highmark Health (Pittsburgh, PA)
- …6 years experience in healthcare , provider reimbursement, providing contracting, fraud , waste, and abuse investigations, or related field. **PREFERRED ... strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment...and negotiating Professional Provider fraud , waste and abuse (FWA) settlements and/or healthcare audit consulting… more
- Molina Healthcare (Covington, KY)
- …and actions. + Works with leadership to maintain and revise policies and procedures, fraud , waste, and abuse plans, annual audit work plans, including department ... License, Certification, Association + Active and unrestricted Accredited Health Care Fraud Investigator (AHFI) designation or Certified Fraud Examiner (CFE)… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Special Investigations Unit (SIU) will lead efforts to detect, investigate and prevent healthcare fraud within the pharmacy operations. ; This role combines ... and coordination with other departments to mitigate and remedy fraud , waste and abuse . ;Develop, implement and...law enforcement and regulators. + Credentials such as Certified Fraud Examiner, Accredited Healthcare Fraud … more