- State of Georgia (Fulton County, GA)
- …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... including, but not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations. May be issued a… more
- CVS Health (Hartford, CT)
- …- Bachelor's degree and/or an Associate's degree with three additional years working in health care fraud , waste, and abuse investigations and audits. Pay ... Certified Fraud Examiners (CFE) - An accreditation from the National Health Care Anti- Fraud Association (AHFI). - Billing and Coding certifications such… more
- Molina Healthcare (Covington, KY)
- …prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include ... Services, Claims) to gather documentation pertinent to investigations. + Detects potential health care fraud , waste, and abuse through the identification of… more
- MyFlorida (Miami, FL)
- …writing comprehension and an understanding about legal proceedings and investigations related to health care fraud and abuse. The Florida Medicaid program ... Website (http://www.dms.myflorida.com/workforce\_operations/human\_resource\_management/for\_job\_applicants/e\_verify) . Requisition No: 831449 Agency: Agency for Health Care Administration Working Title: 68063500 -… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud . **What you'll bring:** + Bachelor's Degree in ... Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) years of active… more
- Commonwealth Care Alliance (Boston, MA)
- …to Us:** The Associate Investigator works with a growing team conducting and managing Health Care Fraud , Waste and Abuse investigation and prevention ... background or formal data analyst background preferred. + Prior experience in health care compliance, regulation, SIU, government agency or similar position… more
- State of Colorado (Denver, CO)
- …detailed research and analysis of investigative information relating to alleged violations of health care fraud , fraudulent administration of the Medicaid ... the Office of the Attorney General! The Colorado Medicaid Fraud Control Unit (COMFCU) in the Consumer Protection Section...and/or the alleged abuse or neglect of patients in health care facilities governed by the State… more
- Providence (OR)
- …+ Current certification as Certified Coding Professional (CPC) + Current certification in health care fraud investigation, such as Accredited Healthcare ... to coding, medical record documentation requirements, healthcare compliance and fraud , waste and abuse to Health Plan...New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more… more
- CVS Health (Hartford, CT)
- …of Certified Fraud Examiners (CFE) or an accreditation from the National Health Care Anti- Fraud Association (AHFI)- Billing and Coding certifications ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to… more
- DCCA (Columbia, MD)
- …Investigations Unit (SIU) experience Education/Certifications: . Bachelor's Degree . Accredited Health Care Fraud Investigator (AHCFI) certification ... timeliness, and business relations. . Demonstrates a clear understanding of fraud operations. . Leads innovation activities. . Ensures appropriate staffing levels.… more
- CACI International (Washington, DC)
- …The Document Management Analyst (DMA) role works closely with the Department of Justice, Health Care Fraud Division attorneys in a fast-paced setting and ... and administrative duties as requested by attorneys for Fraud Section ( Health Care Fraud division) investigations and trials. + Assist with case… more
- Executive Office for US Attorneys and the Office of the US… (Houston, TX)
- …and procedural matters, and sentencing issues. The appeals arise from diverse crimes, such as health care fraud , mortgage fraud , other complex fraud ... includes, in part, paid vacation; sick leave; holidays; telework; life insurance; health benefits; and participation in the Federal Employees Retirement System. The… more
- New York State Civil Service (New York, NY)
- …and the New York City Police Department; and participates in meetings of the FBI Health Care Fraud Task Force;* Works closely with other law enforcement ... the New York City Police Department; and participates in meetings of the FBI Health Care Fraud Task Force;* Works closely with other law enforcement agencies… more
- Executive Office for US Attorneys and the Office of the US… (Muskogee, OK)
- …organized crime, terrorism, international narcotics, child exploitation/child pornography, human trafficking, health care fraud , complex securities and ... includes, in part, paid vacation; sick leave; holidays; telework; life insurance; health benefits; and participation in the Federal Employees Retirement System. The… more
- Humana (Columbus, OH)
- …lines of business; + Advising on Medicare Advantage rules and regulations and related health care fraud and abuse laws, including the Anti-kickback statute ... of experience in health law at a law firm or in-house health care organization + Experience in Medicare, Medicaid, or similar regulatory work + Strong legal… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …laws, regulations and company policies, including but not limited to, FDA regulations, OIG guidance, health care fraud and abuse, Open Payments and HIPAA. + ... Child Daycare, Cafe, Fitness Center** _*US Only_ _**Limited locations_ We care about your health and financial well-being and offer the resources you need to… more
- Independent Health (Buffalo, NY)
- …Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in ... record documentation, and reviewing other documentation, in accordance with Independent Health 's Fraud Prevention Plan. Reviewing output from computerized … more
- JPMorgan Chase (Plano, TX)
- …and programs to meet employee needs, based on eligibility. These benefits include comprehensive health care coverage, on-site health and wellness centers, a ... Join the team that ensures our customers receive the best fraud detection and protection in the industry. As a Fraud Operations Executive Director for Merchant… more
- UMB Bank (Columbus, OH)
- …sponsored benefit plan including medical, dental, vision, and other insurance coverage; health savings, flexible spending, and dependent care accounts; adoption ... **Duties & Responsibilities** The Manager, Card Fraud Claims, will oversee and manage the UMB...UMB isn't comprised of workers, but of people who care about their work, one another, and their community.… more
- UMB Bank (Kansas City, MO)
- …sponsored benefit plan including medical, dental, vision, and other insurance coverage; health savings, flexible spending, and dependent care accounts; adoption ... This position will report directly to the Director, Enterprise Fraud Operations and will be responsible for managing a...UMB isn't comprised of workers, but of people who care about their work, one another, and their community.… more
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