- State of Colorado (Denver, CO)
- Medicaid Fraud Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057010) Apply Medicaid Fraud ... 009. The Consumer Protection Section is seeking an experienced investigator to join the Colorado Medicaid Fraud ,...and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries. + To hold… more
- State of Colorado (Denver, CO)
- Compliance Investigator I (Medicaid Fraud ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5058947) Apply Compliance Investigator I ... five (5) years of professional experience in investigation either as an investigator , investigative journalist, auditor or fraud specialist, or other field… 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 ... Office of the Attorney General Department of Law Medicaid Fraud Division - Investigator The mission of...the necessary documents to identify and investigate health care fraud and patient abuse, including medical records,… more
- Bank of America (Chicago, IL)
- GFC Investigator (Brokerage - AML/ Fraud ) Charlotte, North Carolina;Jersey City, New Jersey; Pennington, New Jersey; Dallas, Texas; Chicago, Illinois **To proceed ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Charlotte/GFC- Investigator --Brokerage AML- Fraud -\_25035332) **Job Description:** At Bank of… 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...control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare… more
- CVS Health (Hartford, CT)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- MVP Health Care (Schenectady, 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 ... involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:...to the above requirements: A duly licensed or authorized medical professional, including but not limited to MD or… more
- Guardian Life (New York, NY)
- …+ Ability to spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and manual exception reports and ... filings, including, but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business partners. Assists in… more
- US Bank (Knoxville, TN)
- …the following (some may vary based on role, location or hours): + Healthcare ( medical , dental, vision) + Basic term and optional term life insurance + Short-term and ... long-term disability + Pregnancy disability and parental leave + 401(k) and employer-funded retirement plan + Paid vacation (from two to five weeks depending on salary grade and tenure) + Up to 11 paid holiday opportunities + Adoption assistance + Sick and… more
- CareFirst (Baltimore, MD)
- …**Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) + Certified Expert Coder-AHIMA or ... anti- fraud software analysis, and appropriately sourced reference materials. Investigator ensures timely maintenance and organization of case file documentation… more