- LA Care Health Plan (Los Angeles, CA)
- …Field Experience Required: At least 7 years of experience in healthcare compliance, fraud investigations , law enforcement, or related field. At least 5years of ... Director, Compliance on Special Investigations Unit and Fraud , Waste and...(DHCS), and state/federal requirements. Ensure effective case intake, triage, investigation , tracking, and resolution processes, including referral to law… more
- Zelis (Boston, MA)
- …and the personal interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute significantly to ... fraudulent activities by conducting comprehensive reviews of all internal and external fraud monitoring alerts, performing fraud investigations , and… more
- BlueCross BlueShield of North Carolina (NC)
- …$62,100.00 - $111,800.00 **Skills** Depositions, Evidence Collection, Forensic Accounting, Fraud Investigations , Investigation Techniques, Investigative ... is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company....gaps on the business/organization. + In the course of investigation , may be required to provide deposition and/or testimony… more
- Humana (Tallahassee, FL)
- …& Abuse Investigations required + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies ... community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of...requires an in-depth evaluation of variable factors. The Senior Fraud and Waste Professional coordinates investigation with… more
- Capital One (St. Cloud, MN)
- Work From Home - Senior Complaints Coordinator - FDO Escalations - Fraud Account Management Investigations Solutions (FAMISE) **Are you looking for a challenging ... experience using Google Suite or Microsoft Office + At least 1 year of Fraud or Disputes experience **Preferred Qualifications** + At least 4 years of Customer… more
- Humana (Denver, CO)
- …our caring community and help us put health first** The Manager, Fraud and Waste Investigator: Nurse Audit/Review performs clinical audit/validation processes to ... objectives and determines approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/Review validates and interprets medical… more
- State of Georgia (Fulton County, GA)
- …documentation for investigation and prosecutorial purposes in health care fraud and patient abuse investigations . Utilizes computers and the appropriate ... Division. Duties & Responsibilities: Investigators conduct health care fraud investigations . Assists criminal justice personnel, including,...active and in good standing. . Twelve months of fraud investigation or related experience. . Law… more
- Bank of America (Pennington, NJ)
- …Investment Management. In the investigative role, the Investigator conducts complex investigations , including fraud committed by external parties, securities ... GFC Investigator (Brokerage - AML/ Fraud ) Phoenix, Arizona;Pennington, New Jersey; Plano, Texas; Dallas,...The Global Financial Crimes Compliance (GFCC) Investigator performs end-to-end investigations across one or more lines of business relevant… more
- CIBC (Chicago, IL)
- …(https://www.cibc.com/en/about-cibc.html) Responsibilities The Fraud Analyst will report to the Fraud Investigations Manager of US Region Fraud ... St, 8th Fl **Employment Type** Regular **Weekly Hours** 40 **Skills** Financial Crime Investigations , Fraud Investigations , Fraud Monitoring, Time… more
- Columbia Bank (Phoenix, AZ)
- …Director who can design, implement, and maintain a best-in-class AML and Fraud Investigations program, including robust transaction monitoring systems, to ... Provide oversight and support services for groups that impact FID related to fraud investigations and AML transaction monitoring, process and policies. + Working… more
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