- 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 team ... Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve...**Use your skills to make an impact** **WORK STYLE:** Remote , work at home. While this is a … more
- Humana (Santa Fe, NM)
- …of situations or data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law enforcement ... 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 Care Industry?… more
- Magellan Health Services (Boise, ID)
- …- Required License and Certifications - Preferred AHFI - Accredited Healthcare Fraud Investigator - EnterpriseEnterprise, CFE - Certified Fraud ... Job Requirements Responsibilities Minimum of five years of experience in fraud investigations, related behavioral or medical healthcare insurance experience… more
- Humana (Lincoln, NE)
- …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 ...next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Kemper (Doral, FL)
- …Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner ... Our Special Investigator will function as a remote investigator working from her/his residence and...coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Market Regulation Investigator - Insurance Complaint Analyst Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/5138436) Apply Market Regulation ... Investigator - Insurance Complaint Analyst Salary $62,337.60...vital role in identifying and mitigating risks associated with fraud and misconduct in the Insurance Industry… more
- USAA (Dallas, TX)
- …claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and regulations and policies and procedures. ... Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. + Collects... in investigating claims. + Collects evidence of potential fraud through field or remote interviews and… more
- AmeriHealth Caritas (Columbia, SC)
- …We are looking for the next generation of health care leaders. **This position is remote however, you must reside in South Carolina and be willing to travel within ... administrative services. Discover more about us at www.amerihealthcaritas.com. The Investigator is responsible for conducting comprehensive investigations of reported,… more
- EFI Global (Los Angeles, CA)
- …the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a ... residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud , this includes large loss, large fire… more
- EFI Global (St. Paul, MN)
- …the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a ... residences.** **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud , this includes large loss, large fire… more
- Centene Corporation (Frankfort, KY)
- …A license in one of the following is required: Other Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE). Other Pharmacy ... a subject matter expert for the Contractor's Program Integrity unit to reduce Fraud , Waste and Abuse of Medicaid services within Kentucky. Provides direction and… more
- Command Investigations (Greenville, SC)
- …excellence. What you'll get: + A dedicated position as a surveillance investigator . + A steppingstone into the realms of investigations, security, and law ... need to apply: + Approximately 1 years experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Hold a valid Private Investigator … more
- Command Investigations (Minneapolis, MN)
- …excellence. What you'll get: + A dedicated position as a surveillance investigator . + A steppingstone into the realms of investigations, security, and law ... need to apply: + Approximately 1 year of experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Able to obtain Private Investigator … more
- Command Investigations (Washington, DC)
- …excellence. What you'll get: + A dedicated position as a surveillance investigator . + A steppingstone into the realms of investigations, security, and law ... need to apply: + Approximately 1 years experience relating to Work Compensation/ Fraud /Mobile and Stationary surveillance + Hold a valid Private Investigator … more
- Command Investigations (TN)
- …possible, setting the bar high for investigative excellence. Seeking experienced Insurance Fraud Investigators with commercial or personal lines experience, ... our website and find out why at www.GoCommand.com . The Claims/Surveillance Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or… 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 ... a health insurance exchange (also called Health Insurance Marketplace)...CMS; and recommend referrals to law enforcement if potential fraud and abuse is identified.** **HOW YOU WILL MAKE… more
- Centene Corporation (Columbus, OH)
- …NE, and OH.** **Position Purpose:** Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims ... investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. + Conduct investigations of potential waste, abuse, and fraud … more
- Truist (Greensboro, NC)
- …one of the locations listed. No other locations will be considered. No remote option available. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Following is a summary of ... for case or alert questions and support. 5. Responsible for detecting fraud , suspicious transactions or those in violation of applicable BSA/AML/OFAC laws and… more
- Marriott (Bethesda, MD)
- …due to the nature of the business needs. This position is eligible for remote work. CANDIDATE PROFILE Education and Experience Required 3 years of experience in ... customer service, operations, risk management, fraud mitigation or related field BS/BA in accounting, finance,...flexible spending account, dependent care flexible spending account, life insurance , disability insurance , accident insurance ,… more
- Zelis (Boston, MA)
- …certification as a Certified Fraud Examiner (CFE), Accredited Health Care Fraud Investigator (AHFI), Health Care Anti- Fraud Associate (HCAFA), Certified ... interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute...FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations… more