- 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 ... Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying...claims and medical records prior to payment. Researches new healthcare -related questions as necessary to aid in investigations. +… more
- Molina Healthcare (KY)
- …Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location +...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Elevance Health (Indianapolis, IN)
- …independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client ... **Senior Investigator ( Investigator Sr)** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50… more
- Elevance Health (Houston, TX)
- …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds ... ** Investigator II** **Supporting the Payment Integrity line of...business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within… more
- Elevance Health (Louisville, KY)
- …independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client ... ** Investigator Senior** **Supports the Payment Integrity line of...business** _Location: This position will work a hybrid model ( remote and office)._ _Alternate locations may be considered._ _The… more
- Zelis (Morristown, NJ)
- …standard certifications (CCE, EnCE, GCFE, GCFA, GCIH, GREM, GNFA, GPEN, etc.) #LI- Remote Zelis is modernizing the healthcare financial experience by providing ... As the Principal Response Investigator within the Cyber Defense organization, you will...FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work… more
- General Dynamics Information Technology (Fairfax, VA)
- …**Experience:** 3 + years of related experience **Job Description:** **Marketplace Investigator ** **The Affordable Care Act (ACA) requires every state to establish ... administrative actions to CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified.** **HOW YOU WILL MAKE AN IMPACT:** **Conducts… more