- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will ... oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program to prevent...to ensure best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas +… more
- Molina Healthcare (Dayton, OH)
- …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
- Highmark Health (Columbus, OH)
- …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
- Elevance Health (Columbus, OH)
- ** Investigator Senior** **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 Senior** is responsible for the independent identification, investigation… more
- Elevance Health (Mason, OH)
- …the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent ... department throughout investigative process + May assist in training of internal and external entities + Assists in the development of policy and/or procedures to… more
- The Goodyear Tire & Rubber Company (Akron, OH)
- …units and geographies to resolve complex issues. Partners with internal teams and external agencies to support a safe, ethical workplace. **What You'll Do** + Lead ... + Collaborate with internal teams (HR, Legal, Compliance, Internal Audit) and external law enforcement or consultants as needed. + Conduct public records checks… more
- KeyBank (Brooklyn, OH)
- …while verifying/validating customer information and transaction activity via internal and external systems, based on scenario or customer type. Demonstrate strong ... (ie Certified Anti Money Laundering Specialist - CAMS certification, Certified Fraud Examiner - CFE or other accredited related industry certification) Key… more
- ICF (Columbus, OH)
- …+ Credentials such as: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AFHI), or similar. + Proficiency in MS Office Applications ... for a federal health agency. Under this program, ICF will investigate potential fraud , waste, and abuse in Medicare and Medicaid programs. The Program Director will… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …Quality (GQ) strategy. + This position is responsible for ensuring internal and external sites are inspection ready, resources are provided on site and/or remotely ... of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including contract research organizations) and ensure that… more
- KeyBank (Brooklyn, OH)
- …Anti Money Laundering Specialist - CAMS certification, CFCS - Certified Financial Crimes Investigator , Certified Fraud Examiner - CFE or other accredited related ... verifying/validating customer information and transaction activity via internal and external systems, based on scenario or customer type.Demonstrate superior… more