- Elevance Health (Mason, OH)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal ... **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that may… more
- US Bank (Cincinnati, OH)
- …**Additional Skills** Investigators may concentrate on one specific or many different fraud typologies such as external fraud , elder and vulnerable adult ... financial exploitation, technology related fraud , organized fraud rings and anti-money laundering...fraudulent activity, and filing Suspicious Activity Reports (SARs). An investigator may review consumer and commercial DDAs, loans, lines… more
- Molina Healthcare (Dayton, OH)
- **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... reporting, and when appropriate, recovery of money related to health care fraud , waste, and abuse. Duties include performing accurate and reliable medical review… more
- Molina Healthcare (Dayton, OH)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... of experience working in a FWA / SIU or Fraud investigations role for New Jersey/New York location +...CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations preferred To all… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …ensure smooth handoffs to investigation teams. + Analyze triggers related to fraud or money laundering. + Input detailed information into case management systems, ... maintaining accuracy and consistency for investigator 's review. + Appropriately escalate matters associated with financial crimes and fraud activity that warrant… more