- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Sr. Fraud Investigator SIU (Special Investigations Unit) assists in the implementation and daily operation of the organization's ... Investigator will be responsible for identification, investigation and prevention of healthcare fraud , waste and abuse. The primary responsibility of the SIU… more
- Idaho Division of Human Resources (Boise, ID)
- Medicaid Fraud Control Unit Investigator , OAG, Criminal Law Division Posting Begin Date: 2024/09/09 Posting End Date: 2024/11/08 Category: Law Enforcement Sub ... applicant will be assigned to the Attorney General's Medicaid Fraud Control Unit (MFCU). This investigator will...experience with white collar investigations with an emphasis on healthcare or Medicaid fraud . Applications: E-mail resumes… more
- Molina Healthcare (Owensboro, KY)
- …Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position...of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location +… more
- Providence (CA)
- …+ Current certification in health care fraud investigation, such as Accredited Healthcare Fraud Investigator (AHFI), Certification as an Internal Auditor ... behavior change + Provide education related to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan… 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
- Veterans Affairs, Veterans Health Administration (Battle Creek, MI)
- …par with crimes such as homicide, involve an extensive supply chain fraud network, large scale drug diversion, prostitution rings requiring surveillance, and/or ... a VA property. Responsibilities The single focus of the Senior Criminal Investigator is the investigation of suspected major offenses against Veterans Affairs (VA)… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …approach to uncover abuse and neglect of residents and complex financial fraud committed by healthcare providers, including hospitals, nursing homes, pharmacies, ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4500803) Apply ...cyber crimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud … more
- Ada County (Boise, ID)
- Criminal Intelligence Investigator Print (https://www.governmentjobs.com/careers/adacounty/jobs/newprint/4668189) Apply Criminal Intelligence Investigator ... and to use the position's expertise to assist in case work with detectives. The incumbent must use independent...in the OSINT, human trafficking, digital forensics, criminal organizations, fraud , probation and parole or other specialized areas as… more
- Centene Corporation (Frankfort, KY)
- …perspective on workplace flexibility. **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, ... investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations...abuse. + Conduct investigations of potential waste, abuse, and fraud + Document activity on each case … more
- Zelis (FL)
- …Treasury . Qualifications: + Bachelor's degree required + 3+ w orking experience as a Fraud Analyst or Fraud Investigator + Industry experience in financial ... institution , fintech, or payments company required ; Healthcare payments industry, preferred + Knowledge of fraud schemes, fraud prevention methods, and … 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 ... FUNCTIONS:** + Review of medical records and claims. + Investigate potential fraud and over-utilization by performing complex medical reviews of claims and medical… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Finance, Management, Nursing, Criminal Justice, or similar field of study preferred. + Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud ... and prevention. + Manage the day-to-day department performance including case assignments, case development, case ...experience with anti- fraud with specific experience involving healthcare fraud , including a minimum of (3)… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …internal investigations process and capabilities worldwide; including designing and delivering investigator / case manager training for l colleagues throughout the ... GRC Investigations also co-administers and maintains the global Integrity Line and case management system for Olympus Corporation and its family of companies… more