- CDPHP (Albany, NY)
- …for investigating complex insurance cases to detect internal and external fraud and abuse. The Special Investigator will research and document cases ... (4) years of equivalent experience required. + Designation as an Accredited Health Care Fraud Investigator preferred. + Incumbent must meet one of the minimum… more
- IT Concepts (Woodlawn, MD)
- …driven and innovative individuals to join our team. IT Concepts is seeking a Fraud Analyst/ Investigator who will support several projects at a federal agency. ... as well as input from other sources to identify fraud + Communicates with internal and external ...identify fraud + Communicates with internal and external sources related to potentially fraudulent activity + Provides… more
- MUFG (Tempe, AZ)
- …details. Reporting to the Senior Fraud Prevention Manager (Vice President) of Fraud Operations. The Investigator will complete fraud investigations to ... experience and general level of supervision required by the Senior Fraud Prevention Manager. **Major Responsibilities:** + Analyze account transactions to determine… more
- M&T Bank (Amherst, NY)
- …or through the Bank by a customer or non-customer. Makes decisions about fraud regarding customer impact and future steps. Interacts with peers within and outside ... by gathering evidence, analyzing information and documenting findings. + Serve as primary fraud contact on all assigned cases. + Complete special projects in a… more
- BMO Financial Group (Omaha, NE)
- AML and Fraud are both exciting areas within the bank to be involved with. This is a high pace environment in a constantly shifting landscape. Our ideal candidate is ... the execution of strategic initiatives in collaboration with internal and external stakeholders. + Builds effective relationships with internal/ external … more
- Molina Healthcare (Albuquerque, NM)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- Premera Blue Cross (Spokane, WA)
- …(SIU), the ** Investigator III** will be responsible for investigating allegations of external fraud , waste, and abuse (FWA). The reports prepared by this ... Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active experience in auditing and… more
- CVS Health (Baton Rouge, LA)
- …testimony during civil and criminal proceedings- Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach ... health care more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of known or… more
- CVS Health (Springfield, IL)
- …testimony during civil and criminalproceedings *Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach ... care more personal, convenient and affordable. Position Summary: As a Senior Investigator you will conduct high level, complex investigations of known or suspected… more
- CVS Health (Hartford, CT)
- …to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse. Also reports suspected fraud , waste, and ... Fundamental Components: - Conducts investigations of known or suspected acts of healthcare fraud , waste, and abuse - Communicates with federal, state, and local law… more
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