• Investigator , SIU-Miami, Florida

    Molina Healthcare (Miami, FL)
    …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
    Molina Healthcare (12/15/24)
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  • Senior Fraud /AML Investigator

    NBT Bank (Lakeville, CT)
    Pay Range: $27.48 - $36.65 The Senior Fraud /AML Investigator will work fraud and money laundering cases as assigned by the BSA Officer and Security Officer ... patterns of customer activity + Must be a skilled investigator with understanding of types of fraud ...: Includes employer contributions to HSA for High Deductible Health Plan participants. + Dental and Vision Coverage :… more
    NBT Bank (10/16/24)
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  • Senior Healthcare Fraud Investigator

    CVS Health (Tallahassee, FL)
    …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 ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable....**Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations… more
    CVS Health (11/21/24)
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  • Senior Fraud and Waste Investigator

    Humana (Indianapolis, IN)
    …of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will ... oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program to prevent...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (12/19/24)
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  • Fraud Investigator

    Zions Bancorporation (Midvale, UT)
    …are endless. You bring the talent; we bring the opportunity. We are currently seeking a Fraud Investigator to join our team. This position will be full time work ... including the case management system. + Keeps current on fraud and BSA/AML investigative operations and the application of...Health Savings (HSA), Flexible Spending (FSA) and dependent care accounts + Paid Training, Paid Time Off (PTO)… more
    Zions Bancorporation (12/18/24)
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  • Investigator - Medicaid Fraud

    State of Minnesota (St. Paul, MN)
    …Minnesota Medicaid program. The investigator reviews complaints against public health care providers; evaluates and analyzes claims data, medical records, ... **Working Title: INVESTIGATOR - MEDICAID FRAUD DIVISION** **Job...Minnesotans and our state. Investigators conduct criminal investigations into health care providers suspected of defrauding the… more
    State of Minnesota (12/23/24)
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  • Fraud and Waste Investigator

    Humana (Madison, WI)
    **Become a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent ... and abusive practices. The Fraud and Waste Professional 2 work assignments are varied...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (12/19/24)
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  • Financial Investigator -Criminal Enforce

    MyFlorida (Miami, FL)
    FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004722 Date: Dec 20, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 843021 Agency: Office of Financial Regulation Working Title: FINANCIAL INVESTIGATOR -CRIMINAL ENFORCE - 43004722 Pay Plan: Career Service Position Number:… more
    MyFlorida (01/08/25)
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  • Senior Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    …or law enforcement, at least 3 of which must be health care specific and includes independently conducting healthcare fraud , waste, and abuse investigations ... of all levels. **Licenses/Certifications** Certified Insurance Fraud Investigator (CIFI) Preferred Certified Expert Coder-AHIMA or AAPC Preferred **Knowledge,… more
    CareFirst (11/27/24)
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  • Law Enforcement Investigator II

    MyFlorida (Miami, FL)
    …neglect of patients, investigate the alleged misappropriation of patients private funds in health care facilities, and safeguarding the privacy rights of all ... LAW ENFORCEMENT INVESTIGATOR II - 41001296 Date: Jan 7, 2025...and/or the alleged abuse or neglect of patients in health care facilities governed by the State… more
    MyFlorida (01/08/25)
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  • Senior Investigator , Special Investigation…

    CVS Health (Columbus, OH)
    …situation. **Education** + Bachelor's degree or equivalent experience (3-5 years of working health care fraud , waste and abuse investigations). **Pay Range** ... convenient and affordable. **Position Summary** + As 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
    CVS Health (01/11/25)
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  • Investigator - Criminal

    State of Georgia (Fulton County, GA)
    …of our Medicaid Fraud Division. Duties & Responsibilities: Investigators conduct health care fraud investigations. Assists criminal justice personnel, ... Office of the Attorney General Department of Law Medicaid Fraud - Criminal Investigator Salary: High 40's...limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient… more
    State of Georgia (10/18/24)
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  • Investigator

    Highmark Health (Dover, DE)
    …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations...+ 1 year in Financial Analysis in an acute care hospital or health insurance setting +… more
    Highmark Health (11/13/24)
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  • Special Investigator - Managed Care

    AmeriHealth Caritas (Columbia, SC)
    …and sequential thinker. + A minimum of 3-5 years experience conducting comprehensive health care fraud ;investigations; interacting with state, federal and ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care more
    AmeriHealth Caritas (12/13/24)
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  • Senior Corporate Investigator

    Commerce Bank (Kansas City, MO)
    …success, helping businesses thrive, and making sure people and their money are taken care of. And our commitment doesn't stop there. Our culture is about our people, ... Bank and the Bank's stakeholders. Essential Functions + Ensure fraud alerts are issued to lines of business timely...stakeholders + Answer calls and emails routed to the investigator and the Duty Line and Resource mailbox +… more
    Commerce Bank (12/12/24)
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  • Criminal Investigator

    Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
    …influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Participation in the Coronavirus Disease 2019 ... (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for… more
    Veterans Affairs, Veterans Health Administration (12/29/24)
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  • Senior Investigator , Pharmacy (Aetna SIU)

    CVS Health (Frankfort, KY)
    …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 ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable....**Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator (Pharmacy) to join our Special… more
    CVS Health (01/11/25)
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  • Investigator /Special Agent (1-3)

    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/4733817) Apply  ...prosecutes allegations of abuse, and neglect of residents in health care facilities. The MFCU utilizes a… more
    Louisiana Department of State Civil Service (11/20/24)
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  • Investigator , DA

    The County of Los Angeles (Los Angeles, CA)
    …investigation of various types of fraud (eg, auto insurance, workers' compensation, health care , real estate, and consumer). You may also work directly with ... INVESTIGATOR , DA Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2434815) Apply  INVESTIGATOR , DA Salary $82,080.00 - $110,616.00 Annually… more
    The County of Los Angeles (01/06/25)
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  • Investigator , SIU RN

    Molina Healthcare (Meridian, ID)
    …prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include ... the medical necessity, level of services, and/or appropriateness of care in cases. The SIU Investigator is...to gather documentation pertinent to investigations. * Detect potential health care fraud , waste, and… more
    Molina Healthcare (01/04/25)
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