- Sanford Health (Fargo, ND)
- …Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred Nursing or other clinical experience highly preferred ... health insurance investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud … more
- Elevance Health (Norfolk, VA)
- ** Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Fraud Investigator II** is...Registered Nurse strongly preferred + Law Enforcement dealing with Healthcare Fraud Please be advised that Elevance… more
- Elevance Health (Richmond, VA)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying… more
- MVP Health Care (Tarrytown, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Clinical Investigator ** to join #TeamMVP. This is the opportunity for you ... professional investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
- NTT DATA North America (Boston, MA)
- … Examiner (CFE), Certified Professional Coder (CPC), or Accredited Health Care Fraud Investigator (AHFI) preferred Familiarity with Partial Hospitalization and ... overall sourcing strategy. NTT DATA's Client is seeking a Investigator for Health Plan Special Investigations Unit ( "SIU...assigned to conduct pre-payment reviews of medical records for healthcare claims in one or more of the following… more
- State of Georgia (Fulton County, GA)
- …Georgia Medicaid Program. Participates as a member of an interdisciplinary team in Healthcare fraud investigations, and provides support to members of other ... of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward...eligibility of providers as requested. + Assists prosecutors in Healthcare Fraud investigations by reviewing provider and… more
- Lane County (OR)
- Investigator Print (https://www.governmentjobs.com/careers/lanecountyor/jobs/newprint/5068942) Apply Investigator Salary $85,176.00 - $116,584.00 Annually ... the Position As an integral member of our public safety team, the Investigator will support Deputy District Attorneys across Criminal, Family Law (Child Support… more
- CVS Health (Harrisburg, PA)
- … conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply ... providers, claimants, etc. - Researches and prepares cases for clinical and legal review. - Documents all appropriate case...law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates… more
- CVS Health (Hartford, CT)
- …investigations to effectively pursue the prevention, detection, investigation and prosecution of healthcare fraud , waste, and abuse. Also reports suspected ... **Fundamental Components:** - Conducts investigations of known or suspected acts of healthcare fraud , waste, and abuse - Communicates with federal, state,… more
- CVS Health (Albany, NY)
- …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/Pharmacy/Broker Investigative ... manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key...claimants and customers. + Researches and prepares cases for clinical and legal review. + Documents all appropriate case… more