- Humana (Oklahoma City, OK)
- …**Required Qualifications** + **Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of healthcare ... Oklahoma Medicaid Team. This team of Investigators conducts investigations into allegations of fraud , waste, and abuse involving providers who submit claims to… more
- Elevance Health (Chicago, IL)
- …responsible for identifying issues and/or entities that may pose potential risks associated with fraud and abuse . **How you will make an impact:** + Performs ... billing and processing guidelines and to identify opportunities for fraud and abuse prevention and control. +...claims 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 (3820) Occupational Category Legal Salary Grade NS Bargaining Unit M/C… 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
- Providence (Oakland, CA)
- …related to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan staff, vendors and contracted ... provider, facility or health insurance company. + 2 years Fraud and Abuse audit experience in a...software/tools. **Preferred Qualifications:** + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. +… more
- Danaher Corporation (Deer Park, IL)
- …diagnostic/IVD industry. + Experience in the medical device industry. + Experience with healthcare regulation, including fraud and abuse (eg, anti-kickback), ... FDA and CE/IVDR for medical devices, and data use and privacy (eg, HIPAA, GDPR). Key Competencies + Healthy ambition, defined as an innate drive to work hard, take ownership, and be a person of influence in the organization, producing great results and… 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
- Molina Healthcare (Nampa, ID)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse . Duties include performing accurate and reliable ... for developing leads presented to the SIU to assess and determine whether potential fraud , waste, or abuse is corroborated by evidence. + Conducts both… more
- Sharp HealthCare (San Diego, CA)
- …+ experience in healthcare operations and related regulatory requirements such as Fraud , Waste, and Abuse , Privacy and Security, Conflict of Interest, and ... Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified in Healthcare Privacy Compliance (CHPC) - Health Care Compliance Association (HCCA); Bachelor's… more