- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity ... areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities...+ Bachelor's degree + At least 2 years of healthcare fraud investigations and auditing experience +… more
- CareFirst (Columbia, MD)
- …+ Independently or as lead in part of an assigned team develop and conduct healthcare fraud , waste, and abuse investigations of all levels (low to complex). ... **Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) and + Certified Expert Coder-AHIMA… more
- CVS Health (Columbus, OH)
- …make health care more personal, convenient and affordable. **Position Summary:** As a Senior Investigator you will conduct high level, complex investigations of ... known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex… more
- CVS Health (Wellesley, MA)
- …Unit is seeking a Sr. Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing and managing ... role. + Relevant certifications (eg, Certified Fraud Examiner (CFE), accredited healthcare fraud investigator (AHFI) **Education:** + Bachelor's degree… more
- Sharp HealthCare (San Diego, CA)
- …Qualification Requirements** + Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) Certification - Preferred **Essential ... and employer business practices. **What You Will Do** The Senior Fraud , Waste and Abuse Specialist at...finance, business or related field. + 5 Years in healthcare fraud investigation, preferably in a health… more
- CVS Health (Columbus, OH)
- …+ Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse. + Conduct Investigations to prevent payment ... local law enforcement agencies in the investigation and prosecution of healthcare fraud . + Demonstrates high level of knowledge and expertise during interactions… more
- Elevance Health (Mendota Heights, MN)
- …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...claims. + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company… 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...claims. + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company… more
- Zelis (Morristown, NJ)
- …recruiters or senior professionals at Zelis. Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and ... As the Principal Response Investigator within the Cyber Defense organization, you will...security, technology risk, and non-technical areas such as legal, fraud , privacy, and reputation risk + Identify process and… more
- Fallon Health (Worcester, MA)
- …this work is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar ... LinkedIn. **Brief summary of purpose:** Under the general direction of the Senior Internal Audit Manager, theAnalyze and interpret patient medical records pertaining… more
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