- Humana (Baton Rouge, LA)
- …community and help us put health first** Humana's Special Investigations Unit is seeking a Fraud and Waste Investigator to join the Louisiana Medicaid Team. ... as well as collaborate with Humana's Program Integrity partners. As a Fraud and Waste Investigator , you will conduct investigations into allegations of… more
- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for overseeing the ... monitoring and enforcement of the Fraud , Waste , and Abuse (FWA) program. This role aims to prevent and detect potential FWA activities in accordance with state… more
- Humana (Columbia, SC)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... alleged or suspected fraud involving South Carolina's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation with law enforcement… more
- Molina Healthcare (NE)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9. The DSS Accountability ... state data sources. BFI is recruiting for three (3) Fraud Investigator II to function as Senior...who will: - Conduct complex investigations into allegations of fraud , waste , and/or abuse of social services… more
- MyFlorida (Jacksonville, FL)
- …the Bureau of Public Assistance Fraud is to aggressively identify and eliminate fraud , waste , and abuse to safeguard the integrity of taxpayer funded public ... FINANCIAL CRIME INVESTIGATOR I (PENDING RECLASSIFICATION) - 43061920 Date: May 7, 2025 The State Personnel System is an E-Verify employer. For more information click… more
- Highmark Health (Tallahassee, FL)
- …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
- MTA (New York, NY)
- Construction Auditor/ Investigator Series Job ID: 10587 Business Unit: MTA Inspector General Location: New York, NY, United States Regular/Temporary: Regular ... Transportation Authority Office of the Inspector General Job Title: Construction Auditor/ Investigator Series Closing Date: Open Until Filled Agency: Office of the… more
- Molina Healthcare (NM)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable ... may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to...and/or health plan members in order to determine whether fraud , waste , or abuse may have occurred.… more
- AmeriHealth Caritas (Washington, DC)
- …Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of ... Falls Church VA. Site visits required as needed. The Investigator is responsible for conducting comprehensive investigations of reported,...potential; fraud , waste and/or abuse with a focus… more
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