- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve as Humana's Program Integrity Officer,… more
- Point32Health (Canton, MA)
- …groups, and committees. + Responsible for leading complex provider investigations related to fraud , waste and abuse, and developing action plans to address the ... currently seeking highly motivated individuals to join our organization as a Fraud Operations Specialist within our Special Investigations Unit ("SIU"). The Fraud… more
- AmeriHealth Caritas (Columbia, SC)
- …Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported,...potential; fraud , waste and/or abuse with a focus… more
- Highmark Health (Harrisburg, PA)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... for conducting investigations of organizational or functional activities related to alleged fraud , waste and abuse perpetrated by providers, members, facilities,… 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
- Point32Health (Canton, MA)
- …prevent future loss. This role will be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste , and abuse, and developing action plans to address… more
- Centene Corporation (Frankfort, KY)
- …A license in one of the following is required: Other Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE). Other Pharmacy ... subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and… more
- CVS Health (Columbus, OH)
- …the state of Ohio + 4+ years investigative experience in the area of healthcare fraud , waste and abuse matters. + Working knowledge of medical coding; CPT, ... each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of...with an additional four+ years working on health care fraud , waste , and abuse investigations and audits;… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …retrospective investigation of suspect claims and assisting in initial development of fraud , waste , abuse and over-payment recovery cases. This includes learning ... internal resources as well as complying with state and federal requirements for fraud , waste and abuse detection and prevention. Your Responsibilities * Analyze… more
- UPMC (Pittsburgh, PA)
- …the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud , waste and abuse (FWA) cases, as well as researching and ... has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday...data in order to identify potential FWA. The SIU Investigator is also responsible for maintaining the FWA case… more
Related Job Searches:
Dental Fraud Waste Investigator,
Fraud,
Investigator,
Senior Fraud Waste Investigator,
Waste