- Molina Healthcare (Covington, KY)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud ... reporting, and when appropriate, recovery of money related to health care fraud , waste, and...on allegations of FWA and/or may determine appropriateness of care . The SIU Investigator is also responsible… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Nurse (RN), Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), or Accredited Health Care Fraud Investigator (AHFI) preferred. + (2) ... a member of Premera's Special Investigations Unit (SIU), the ** Investigator III** will be responsible for investigating allegations of... Examiners (ACFE) to keep apprised of developments in health care fraud . **What you'll… more
- DCCA (Columbia, MD)
- …Special Investigations Unit (SIU) experience Education/Certifications: . Bachelor's Degree . Accredited Health Care Fraud Investigator (AHCFI) ... timeliness, and business relations. . Demonstrates a clear understanding of fraud operations. . Leads innovation activities. . Ensures appropriate staffing levels.… more
- Independent Health (Buffalo, NY)
- …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Fraud Investigator develops, implements and administers the IH anti- ... Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in… more
- LTCG (MN)
- …Outlook, Access, PowerPoint and research tools Preferred Qualifications * Designations as: Certified Fraud Examiner, Health Care Anti- Fraud Associate or ... its customers. With illumifin, there's a brighter future A SIU/ Fraud Investigator is responsible for working with... fraud detection and investigations within the long-term care or health care industry… more
- State of Georgia (Fulton County, GA)
- …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... Investigator - Medicaid Fraud Division Georgia...limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient… more
- State of Maine, Bureau of Human Resources (Bangor, ME)
- Fraud Investigator Bangor , Maine ,...operates two state psychiatric hospitals, and provides oversight to health care providers. The Office for Family ... Code:5040 Grade: 22 Salary:$45,801.60 -$ 61,443.20Position Number: 02000-2291Location: Bangor As a Fraud Investigator you will: * Investigate and prepare cases… more
- Ally (Tallahassee, FL)
- …evolving, so shouldn't your opportunities be, too? **The Opportunity** The Ally Invest Fraud Investigator works with the various teams within operations to ... all important to them. Our focus is on the health and safety of our teammates as well as...investigate and deter fraud against Ally Invest. This role requires the ability… more
- Ventura County (Ventura, CA)
- District Attorney Investigator I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4165939) Apply District Attorney Investigator I/II ... for prosecution. The Bureau is staffed with a chief investigator , a deputy chief investigator , 3 commanders,...wide range of investigations from homicide to complex white-collar fraud schemes. The Bureau of Investigation has three divisions:… more
- CVS Health (Baton Rouge, LA)
- …levels in any situation.Education: - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. Pay Range The ... more personal, convenient and affordable. Position SummaryAs a Senior Investigator you will conduct high level, complex investigations of... Examiners (CFE), or an accreditation from the National Health Care Anti- Fraud Association (AHFI)-… more
- MyFlorida (Miami, FL)
- …of patients, investigate the alleged misappropriation of patients private funds in health care facilities. This is independent work conducting investigations of ... LAW ENFORCEMENT INVESTIGATOR II - 41000982 Date: Jun 17, 2024...Annually Position Summary: This position is in the Medicaid Fraud Unit in Miami, Florida. The Attorney General's Medicaid… more
- Commonwealth Care Alliance (Boston, MA)
- …appropriateness of coding, care , sufficiency of documentation and compliance with health care regulations. + Identify trends and concerns related to ... (Word, Excel, PowerPoint, and Access). **Desired Experience:** + Prior experience in health care compliance, regulation, SIU, government agency or similar… more
- CVS Health (Hartford, CT)
- …of your health . This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with ... culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary This… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …is a state law enforcement agency, and it's mission is to investigate and prosecute health care providers who have defrauded the Medicaid program. The MFCU also ... INVESTIGATOR /SPECIAL AGENT (1-3) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4500803) Apply ...prosecutes allegations of abuse, and neglect of residents in health care facilities. The MFCU utilizes a… more
- Commonwealth Care Alliance (Boston, MA)
- …The Associate Investigator works with a growing team conducting and managing Health Care Fraud , Waste and Abuse investigation and prevention activities ... background or formal data analyst background preferred. + Prior experience in health care compliance, regulation, SIU, government agency or similar position… more
- Guidehouse (San Antonio, TX)
- …Parental Leave + 401(k) Retirement Plan + Basic Life & Supplemental Life + Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts + ... **Job Family** **:** Investigator **Travel Required** **:** Up to 10% **Clearance...OFAC Sanctions, Anti-Money Laundering, KYC, CDD, EDD and/or Financial Fraud Investigations. + Understanding of the legal, corporate governance,… more
- State of Michigan (Flint, MI)
- Foster Care Case Manager/CPS Investigator - Services Specialist 9-12 - Current vacancies Print ... (https://www.governmentjobs.com/careers/michigan/jobs/newprint/1511372) Apply Foster Care Case Manager/CPS Investigator - Services Specialist 9-12 - Current… 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
- CVS Health (Trenton, NJ)
- …- 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 as… more
- MyFlorida (Miami, FL)
- SENIOR FINANCIAL INVESTIGATOR - 43004876 Date: Jun 12, 2024 Location: MIAMI, FL, US, 33128 The State Personnel System is an E-Verify employer. For more information ... No: 828525 Agency: Office of Financial Regulation Working Title: SENIOR FINANCIAL INVESTIGATOR - 43004876 Pay Plan: Career Service Position Number: 43004876 Salary:… more
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