- KPH Healthcare Services, Inc. (Oklahoma City, OK)
- …the specific position **Required Training:** + HIPPA Privacy & Security Course + Fraud , Waste, and Abuse Course **Job Skills Required:** + Exceptional attention ... to detail, strong customer service, interpersonal and communication skills + Must be able to effectively communicate internally and externally, via phone and through email + Strong PC skills required with a focus on Excel proficiency + Must be able to work… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse , and waste. The Bureau of...(MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans. This OPS Government… more
- Point32Health (Canton, MA)
- …Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste, and abuse , and developing action plans to address ... prevent future loss. This role will be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and military experience will be considered. * Experience using data analysis tools (eg Healthcare Fraud Shield, etc.) * 1+ years staff, team lead or project ... performance feedback and encourage growth and development of staff. * Accredited Healthcare Fraud Investigator (AHFI) in good standing through the National… more
- Highmark Health (Denver, CO)
- …Analytics will work closely with Senior Data Scientists to support Highmark's Fraud , Waste, and Abuse identification efforts. Daily responsibilities will involve ... the in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect...the business. - Collaborate with senior team members on Fraud , Waste, and Abuse identification initiatives to… more
- Centene Corporation (Oklahoma City, OK)
- …perspective on workplace flexibility. **Position Purpose:** Develop, implement and manage strategic fraud , waste and abuse (FWA) activities by maintaining state ... compliance in billing and claims payment + Serve as a lead and investigate all possible fraud , waste and abuse referrals + Develop customized fraud plans to… more
- UnityPoint Health (Cedar Rapids, IA)
- …for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions or concerns regarding compliance ... aware of hospital and department compliance for federally funded healthcare programs (eg Medicare and Medicaid) regarding fraud... healthcare programs (eg Medicare and Medicaid) regarding fraud , waste and abuse . Brings any questions… more
- Option Care Health (Bannockburn, IL)
- …key risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse . + Perform data analysis and review of documentation to ... related to billing and coding, privacy and security, and fraud , waste and abuse , including but not...Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or similar certification preferred. + Direct… more
- Louisiana Department of State Civil Service (LA)
- …to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud Control Unit (MFCU)… more
- LEES MARKETPLACE (North Salt Lake, UT)
- …up to date on all mandatory training; including but not limited to; Medicare Fraud Waste and Abuse Training, HIPAA Training, and Federal Combat Methamphetamine ... up to date on all mandatory training; including but not limited to; Medicare Fraud Waste and Abuse Training, HIPAA Training, and Federal Combat Methamphetamine… more