- CVS Health (Santa Fe, NM)
- …fraud and abuse **Required Qualifications** + **3 years working on health care fraud , waste , and abuse investigatory and audits required.** + Knowledge of ... Anti- Fraud Association (AHFI), or have a minimum of three years Medicaid Fraud , Waste and Abuse investigatory experience. + Billing and Coding certifications… more
- Molina Healthcare (Rio Rancho, NM)
- …investigation, reporting, and when appropriate, recovery of money related to health care fraud , waste , and abuse. Duties include performing accurate and reliable ... may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to...and/or health plan members in order to determine whether fraud , waste , or abuse may have occurred.… more