- CVS Health (Hartford, CT)
- …heart, each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit ... you will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level,… more
- Highmark Health (Atlanta, GA)
- …+ Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge ... 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year in Financial Analysis… more
- MyFlorida (Tallahassee, FL)
- …Preferred Qualifications: Industry certifications, eg, Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified Financial Crimes ... Investigator ; Certified Insurance Fraud Investigator , Certified Compliance and Ethics Professional. Our Organization and Mission: Under the direction of… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …or a related field) preferred. + Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or ... investigation targets, proposes new methods of data analytics and healthcare informatics to discover Fraud , Waste and...data analytics and healthcare informatics to discover Fraud , Waste and Abuse activities as well as provide… more
- Highmark Health (Pittsburgh, PA)
- …+ Certified Professional Coder- Hospital(CPC-H) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have ... graphs, and charts to timely identify trends and patterns of potential healthcare fraud , waste and abuse. Communicate findings to company management of various… more
- State of Georgia (Fulton County, GA)
- Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67636/other-jobs-matching/location-only) Hot ... Sign Up for Job Alerts The Office of the Attorney General Department of Law Medicaid Fraud Division - Investigator The mission of the Department of Law is to… more
- Elevance Health (Norfolk, VA)
- **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... accommodation is granted as required by law. The **Clinical Fraud Investigator II** is responsible for identifying...Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements: A duly licensed… more
- Molina Healthcare (Lexington, KY)
- …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
- CareFirst (Baltimore, MD)
- …+ Independently or as lead in part of an assigned team develop and conduct healthcare fraud , waste, and abuse investigations of all levels (low to complex). ... **Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) + Certified Expert Coder-AHIMA or… more
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