- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you...outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time… more
- Humana (Santa Fe, NM)
- …analysis of situations or data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law ... health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit....of all do you have a passion for combating Fraud , Waste , and Abuse in the Health… more
- Humana (Lincoln, NE)
- …a part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud and Waste Professional 2 coordinates investigation with law enforcement… more
- Point32Health (Canton, MA)
- …groups, and committees. + Responsible for leading complex provider investigations related to fraud , waste and abuse, and developing action plans to address the ... currently seeking highly motivated individuals to join our organization as a Fraud Operations Specialist within our Special Investigations Unit ("SIU"). The Fraud… more
- Point32Health (Canton, MA)
- …prevent future loss. This role will be responsible for conducting high-volume Pre-Payment Fraud Waste & Abuse ("FWA") investigations under the direction of the ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste , and abuse, and developing action plans to address… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope ... + Prepares recommendations on preventive/corrective measures for the deterrent of future fraud . + Supports other SIU investigators and analysts with their cases by… more
- General Dynamics Information Technology (Fairfax, VA)
- …for SOP updates as needed.** **Prioritize, evaluate, and analyze information for potential fraud , waste , and abuse (FWA) using data related to consumer ... **Experience:** 3 + years of related experience **Job Description:** **Marketplace Investigator ** **The Affordable Care Act (ACA) requires every state to establish… more
- Elevance Health (Indianapolis, IN)
- …evaluate and recommend focused investigative activities involving market trends indicating Fraud , Waste and Abuse within the healthcare industry. **How ... bonus programs (unless covered by a collective bargaining agreement), medical, dental , vision, short and long term disability benefits, 401(k) +match, stock… more
- Zelis (Boston, MA)
- …certification as a Certified Fraud Examiner (CFE), Accredited Health Care Fraud Investigator (AHFI), Health Care Anti- Fraud Associate (HCAFA), Certified ... Fraud in prevention, detection, reporting, and monetary recovery related to financial fraud and healthcare fraud , waste , and abuse. What You'll Do… more
- MyFlorida (Tallahassee, FL)
- …with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator ; Certified ... is to ensure fewer budgeted dollars are lost to fraud , abuse, and waste . The Bureau of...Financial Crimes Investigator ; Certified Insurance Fraud Investigator ; or Certified Compliance and Ethics… more