- Humana (Annapolis, MD)
- …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 ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation with law enforcement… more
- CareFirst (Baltimore, MD)
- …Preferred:** + Certified Fraud Examiner (CFE) + Certified Insurance Fraud Investigator (CIFI) + Certified Coder (CCS or CPC)-AHIMA or ... detection, investigation, and resolution of low to medium levels fraud , waste , and abuse schemes, resulting in...as Certified Fraud Examiner (CFE), Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional… more
- CareFirst (Baltimore, MD)
- …Provide support to investigative teams as they perform all levels of healthcare fraud , waste , and abuse investigations. Oral, written, and other communication ... **ESSENTIAL FUNCTIONS:** + Review of medical records and claims. Investigate potential fraud and over-utilization by performing complex medical reviews of claims and… more