• Fraud and Abuse Investigator

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive ... practices. The Fraud and Waste Professional 2 work assignments are varied...independent determination of the appropriate courses of action. The Fraud and Waste Professional 2 coordinates investigation with law… more
    Humana (05/22/25)
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  • Investigator - Medicaid Fraud

    State of Georgia (Fulton County, GA)
    Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/67636/other-jobs-matching/location-only) Hot ... Office of the Attorney General Department of Law Medicaid Fraud Division - Investigator The mission of...Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. Develops necessary… more
    State of Georgia (04/30/25)
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  • Investigator , SIU (Remote)

    Molina Healthcare (Savannah, GA)
    …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
    Molina Healthcare (03/21/25)
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  • Investigator

    Highmark Health (Atlanta, GA)
    …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
    Highmark Health (05/08/25)
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  • Investigator , SIU RN-Remote

    Molina Healthcare (GA)
    …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
    Molina Healthcare (04/12/25)
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  • Technical Investigator , Integrity…

    Meta (Atlanta, GA)
    …bad actors from abusing the platform. You will investigate holistic networks of abuse to understand and deter adversaries, and then scale solutions that precisely ... to protect Meta users from harm. **Required Skills:** Technical Investigator , Integrity Operations Responsibilities: 1. Apply quantitative skills and incorporate… more
    Meta (04/18/25)
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  • Investigator Assistant

    Elevance Health (Atlanta, GA)
    ** Investigator Assistant** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Assistant** is responsible for providing administrative support to the… more
    Elevance Health (05/23/25)
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