- State of Georgia (Fulton County, GA)
- Criminal Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73115/other-jobs-matching/location-only) Hot ... through this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care… more
- MyFlorida (Pensacola, FL)
- … II position is in the Office of the Attorney General within the Medicaid Fraud Control Unit in Pensacola, Florida. Pay:$60,000.20 - $62,425.00 Annually ... healthcare fraud investigative experience working in a Medicaid Fraud Control Unit, or five (5)...the Medicaid Program, false claims against the Medicaid program, investigating possible criminal violations of… more
- MyFlorida (Miami, FL)
- SENIOR INVESTIGATOR - 41000681 1 1 Date: Dec 8, 2025...in the Office of the Attorney General within the Medicaid Fraud Control Unit in Miami, Florida. Pay: ... Agency: Office of the Attorney General Working Title: SENIOR INVESTIGATOR - 41000681 1 1 Pay Plan: Career Service...or who have prior investigative work experience in a Medicaid Fraud Control Unit and/or 5 years… more
- Louisiana Department of State Civil Service (LA)
- …and provides investigative services in cybercrimes, white collar crimes, and public corruption. Medicaid Fraud Control Unit: The Louisiana Medicaid Fraud ... other Medicaid providers. The MFCU holds offenders accountable through criminal prosecution and civil litigation. From inception through disposition, the nurse… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
- AmeriHealth Caritas (Columbia, SC)
- …services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported, ... alleged or suspected fraud involving the full range of products at the...information which would be considered admissible under generally accepted criminal and civil rules of evidence. + Proactively performs… more
- State of Georgia (Fulton County, GA)
- Intake Coordinator- Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/72587/other-jobs-matching/location-only) Hot ... announcement will serve in the Investigations Section of our Medicaid Fraud & Patient Protection Division. Duties...procedures; (2) state laws and rules governing the Georgia Medicaid program; and (3) criminal laws and… more
- CVS Health (Columbus, OH)
- …it all with heart, each and every day. **Position Summary** As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts ... of healthcare fraud and abuse. Routinely handles cases that are sensitive...to prevent payment of fraudulent claims submitted to the Medicaid lines of business + Researches and prepares cases… more
- Centene Corporation (Frankfort, KY)
- …A license in one of the following is required: Other Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE). Other Pharmacy ... as a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Clinical Investigator ** to join #TeamMVP. This is the opportunity for you if you have ... Workplace** . **Qualifications you'll bring:** + BA/BS degree in criminal justice or a related field, and minimum of...involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements:… more
- Molina Healthcare (Covington, KY)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... position must have the ability to determine correct coding, documentation, potential fraud , abuse, and over utilization by providers and recipients. The position… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste. The Bureau of Medicaid...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; or Certified Compliance and Ethics… more
- MyFlorida (Tampa, FL)
- …30% Serve as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud involving: 1) ... in the Office of the Attorney General within the Medicaid Fraud Control Unit in Tampa, Florida...or Orlando Florida, and involves auditing complex multi-million-dollar healthcare fraud investigations that can result in criminal … more
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