• Nurse and CPC - Clinical Fraud

    Elevance Health (Los Angeles, CA)
    **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal ... live within 50 miles of one of our Elevance Health PulsePoint locations. **Hybrid Workplace Strategy:** 1-2 days in...Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying… more
    Elevance Health (10/01/24)
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  • Senior Healthcare Fraud Investigator

    CVS Health (Hartford, CT)
    …of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti- Fraud Association (AHFI) + Knowledge of Aetna's policies and ... **Education:** + Bachelor's degree or equivalent experience (3-5 years of working health care fraud , waste and abuse investigations). **Pay Range** The… more
    CVS Health (11/19/24)
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  • Senior Healthcare Fraud Investigator

    CVS Health (Tallahassee, FL)
    …and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... Bring your heart to CVS Health . Every one of us at CVS ...complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct… 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...areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities… more
    Humana (11/22/24)
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  • Senior Bank Fraud Investigator

    Ally (Raleigh, NC)
    …your opportunities be, too? **The Opportunity** The primary role of the Senior Bank Fraud Investigator to investigate and deter fraud against Ally Bank. ... problem solver. You will work independently on various bank fraud projects and present findings and solutions to loss...* Supporting your Health & Well-being: flexible health and insurance options including dental and… more
    Ally (11/22/24)
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  • External Fraud Investigator Team…

    US Bank (Columbus, OH)
    …Bank is seeking an experienced, highly motivated, and strategic individual to join our Fraud Investigations team. This role will manage a team of fraud ... The Team Lead will oversee the investigations of multiple fraud typologies, ensure the timely filing of Suspicious Activity...designed to help you and your family boost your health , protect your financial security and give you peace… more
    US Bank (11/19/24)
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  • District Attorney Investigator I/II

    Ventura County (Ventura, CA)
    …real estate fraud , consumer and environmental protection cases, workers' compensation fraud , and automobile insurance fraud . The Administrative Division ... District Attorney Investigator I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4165939) Apply  District Attorney Investigator I/II… more
    Ventura County (10/19/24)
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  • Criminal Investigator III

    State of Colorado (Denver, CO)
    Criminal Investigator III Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4733744) Apply  Criminal Investigator III Salary $71,940.00 - ... of Labor and Employment Division Division of Family and Medical Leave Insurance Opening Date 11/21/2024 Closing Date 12/3/2024 5:00 PM Mountain FLSA Determined… more
    State of Colorado (11/23/24)
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  • Senior Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    fraud , waste, and abuse investigations of all levels. **Licenses/Certifications** Certified Insurance Fraud Investigator (CIFI) Preferred Certified Expert ... Interpret standard State/Federal criminal statutes and criminal and civil law impacting insurance fraud /abuse investigations to preserve the integrity of the… more
    CareFirst (11/27/24)
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  • Supervising Criminal Investigator

    Sacramento County (Sacramento, CA)
    …agreement. RETIREMENT: Social Security and Sacramento County Employees' Retirement System coverage. HEALTH INSURANCE : The County offers a variety of health ... be a variety of benefits available to you. These benefits currently include: health , dental and life insurance ; flexible spending account options for dependent… more
    Sacramento County (11/23/24)
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  • Investigator II, PD-Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …conducting investigations (eg, criminal investigations, administrative-financial crimes, medical or insurance fraud , digital forensic investigations, and private ... INVESTIGATOR II, PD-EMERGENCY APPOINTMENT/HOMELESS INITIATIVE Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4391024) Apply  INVESTIGATOR more
    The County of Los Angeles (10/24/24)
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  • Principal Claims Investigator

    AIG (Atlanta, GA)
    …to ensure that the fraud risk to AIG is minimized. As an Insurance Claims Investigator , you will be responsible for investigating high complexity suspicious ... to manage risk. Join us as a Principal Claims Investigator to play your part in that transformation. It's...insurance claims or suspicious insurance related activities… more
    AIG (09/06/24)
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  • Law Enforcement Investigator II

    MyFlorida (Lake Wales, FL)
    …division investigates a wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation Fraud Investigations + ... LAW ENFORCEMENT INVESTIGATOR II - 43001585 Date: Nov 13, 2024...+ Career training opportunities + $25,000.00 in automatic life insurance coverage + Affordable health insurance more
    MyFlorida (11/14/24)
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  • Law Enforcement Investigator II

    MyFlorida (Tampa, FL)
    …OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: INSURANCE FRAUD CITY: TAMPA COUNTY: HILLSBOROUGH SPECIAL NOTES: ... wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation ...+ Career training opportunities + $25,000.00 in automatic life insurance coverage + Affordable health insurance more
    MyFlorida (11/26/24)
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  • Investigator

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

    CVS Health (Columbus, OH)
    Health policies and procedures is a plus + Experience working Behavioral Health fraud cases **Education** + Bachelor's degree, or an Associate's degree, with ... of fraud and abuse **Required Qualifications** + **3 years working on health care fraud , waste, and abuse investigatory and audits required.** + Knowledge… more
    CVS Health (11/27/24)
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  • Senior Investigator , Special…

    CVS Health (Columbus, OH)
    …of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti- Fraud Association (AHFI) - Knowledge of Aetna's policies and ... information **Education:** - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. **Pay Range** The typical… more
    CVS Health (11/10/24)
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  • Law Enforcement Investigator II

    MyFlorida (Pensacola, FL)
    …OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: INSURANCE FRAUD CITY: PENSACOLA COUNTY: ESCAMBIA ATTENTION CANDIDATES ... wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation ...+ Career training opportunities + $25,000.00 in automatic life insurance coverage + Affordable health insurance more
    MyFlorida (11/15/24)
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  • Investigator , DA

    The County of Los Angeles (Los Angeles, CA)
    …those involving the investigation of various types of fraud (eg, auto insurance , workers' compensation, health care, real estate, and consumer). You may also ... 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 (10/07/24)
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  • Senior Investigator

    Elevance Health (Indianapolis, IN)
    …called upon to represent the Company in court proceedings regarding research findings. + Health insurance experience required with understanding of health ... **Senior Investigator ( Investigator Sr)** _Location: This position...live within 50 miles of one of our Elevance Health PulsePoint locations._ Carelon Payment Integrity is a proud… more
    Elevance Health (11/26/24)
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