- Blue KC (Kansas City, MO)
- …Description Summary:** As part of Blue KC's Special Investigations Unit (SIU), the Fraud Investigator conducts reviews to identify potential fraud , waste, ... AHIMA + FWA Certification: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI) + Medical License: Registered Nurse (RN), Licensed… more
- Elevance Health (St. Louis, MO)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Sedgwick (St. Louis, MO)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Fraud & Compliance Investigator **PRIMARY PURPOSE** **:** To analyze and ... investigate reported, alleged, or suspected fraud and compliance matters related to Sedgwick operations, personnel, third-party vendors, and service providers; to… more
- Allied Universal (St. Louis, MO)
- …+ One or more of the following professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator . Special Investigations Unit (SIU) Specialists investigate claims with red… more
- Highmark Health (Jefferson City, MO)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... :** **JOB SUMMARY** This job is responsible for developing and maintaining an anti- fraud program which includes development and delivery of training and filing of … more
- American Family Insurance - Corporate (St. Louis, MO)
- You will Investigate low to moderately complex insurance fraud activity involving auto and property claims, develop meaningful industry social network and assist ... special investigations leadership in promoting fraud awareness and detection with internal and external partners,...pursue and acquire relevant evidence that accurately resolves all fraud concerns. + Produce a work product that can… more
- Elevance Health (St. Louis, MO)
- ** Investigator Senior - Pharmacy** **Hybrid 1** : This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... investigation and development of complex Healthcare cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent… more
- EFI Global (Kansas City, MO)
- …decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global ... **Must meet minimum certification of NAFI-CFEI certification.** **IAAI Certified Fire Investigator (IAAI-CFI) certification is preferred. Will be required to obtain… more
- Parsons Corporation (St. Louis, MO)
- …Technology, Engineering, or Mathematics disciplines. + DoD Cyber Crimes Investigator certification. + Post-graduate degree in Science, Technology, Engineering, or ... of fraudulent recruitment practices. To learn more about recruitment fraud and how to report it, please refer to https://www.parsons.com/fraudulent-recruitment/… more