- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve as Humana's Program Integrity Officer,… more
- Humana (Little Rock, AR)
- …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 and frequently require interpretation and independent determination of the… more
- Humana (Concord, NH)
- …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
- State of Minnesota (St. Paul, MN)
- **Working Title: Fraud Investigator ** **Job Class: State Program Administrator, Coordinator** **Agency: Department of Employment and Economic Development** + ... to review, evaluate, and conduct investigations - examining allegations of fraud , waste , and abuse. The incumbent will ensure reported and actual instances… 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
- Magellan Health Services (Boise, ID)
- …- Required License and Certifications - Preferred AHFI - Accredited Healthcare Fraud Investigator - EnterpriseEnterprise, CFE - Certified Fraud ... ID. This position is responsible for comprehensive management and ownership of fraud , waste and abuse investigations including development and presentation of… more
- AmeriHealth Caritas (Columbus, OH)
- …Ensures compliance with all requirements related to Special Investigation Units and fraud , waste and abuse investigations. + Conducts investigations of potential ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported,... fraud , waste and/or abuse with a focus… more
- Highmark Health (Harrisburg, PA)
- …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 (Pittsburgh, PA)
- …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
- UPMC (Pittsburgh, PA)
- …Investigations Unit (SIU) Investigator is responsible for investigating assigned dental fraud , waste and abuse (FWA) cases, as well as researching and ... Health Plan has an exciting opportunity for a SIU Investigator ! This is a remote, full-time role working daylight...data analysis to identify, evaluate and measure potential healthcare fraud , waste and abuse to determine valid… more