- Elevance Health (Atlanta, GA)
- …responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse . **How you will make an impact:** + Examines ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. ...next step in the claims lifecycle. + Researches new healthcare related questions as necessary to aid in investigations… more
- Cardinal Health (Charleston, WV)
- …firm or in-house healthcare experience preferred, including commercial transactions and fraud and abuse compliance expertise + Experience working with Group ... to pharmaceutical distribution and services and group purchasing organizations, specifically AKS/ Fraud & Abuse + Identify opportunities for process improvements… more
- SSM Health (Madison, WI)
- …and fueled by our unwavering commitment to ethical excellence, we stand united against fraud , waste, and abuse to protect what matters most: trust in care. ... establishing methods to improve regulatory and legal compliance and reduce vulnerability to fraud , abuse , and waste. + Collaborates to periodically revise the… more
- Abbott (Alameda, CA)
- …of federal and state regulatory requirements, including federal consumer protection laws, fraud and abuse laws, Anti-Kickback issues, Sunshine law, False Claims ... Abbott is a global healthcare leader that helps people live more fully...FDA-regulated company, including knowledge of federal consumer protection laws, fraud and abuse laws, Anti-Kickback law, AdvaMed… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …but not limited to ongoing prioritization and enhancement of business acumen and fraud and abuse expertise. + Oversee Internal Investigations and Conflict of ... Otsuka is a global healthcare company that has been in business for...contacting Accommodation Request ([email protected]) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… 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 ... team. + Must complete all required state, federal and company training programs (ie. HIPAA, Fraud Waste and Abuse , I-pledge, etc.) + Must be trained to provide… more
- United Therapeutics (Research Triangle Park, NC)
- …roles + Full knowledge of healthcare laws and regulations under the FDA, fraud and abuse laws, privacy laws, industry codes + Excellent analytical and ... subject matter expert with a working understanding of FDA regulations, fraud and abuse laws, and industry codes. You have exceptional attention to detail… more
- MyFlorida (Tallahassee, FL)
- …to the receiving and depositing of funds recouped for the Agency due to fraud , abuse , and/or overpayments to Medicaid Providers. This position must have ... ensure timeliness, efficiency and effectiveness of processes used in the recoupment of fraud , abuse , overpayment collections, and past due Revenue accounts. Lead… more
- Ultimate Care Inc (Brooklyn, NY)
- …in promoting adherence to state regulations and internal policies-particularly related to fraud , waste, and abuse . This role involves conducting investigations, ... thorough investigations into reported violations, paraprofessional conflicts, and potential fraud or abuse . + Identify risks and...of two (2) years of administrative experience in a healthcare setting. + 1-3 years of experience working with… more