- Humana (Frankfort, KY)
- …hours/day, 5 days/week. **Required Qualifications** + At least 3 years of healthcare fraud , waste, and abuse investigation and auditing experience + Knowledge of ... a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive… more
- Elevance Health (Chicago, IL)
- **Nurse/CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse ** **Location:** Alternate locations may be considered. This position will work a hybrid ... Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying...and/or entities that may pose potential risks associated with fraud and abuse . **How you will make… more
- Amazon (Arlington, VA)
- …a data-driven, highly motivated, eager to identify threat actors, and organized Investigator of Corporate Fraud Prevention. The selected individual will support ... such as invoices and payments as indicators of theft, fraud , waste or abuse . We are looking...visible role, and a successful candidate is a seasoned investigator , comfortable working with data to derive patterns and… more
- Humana (Baton Rouge, LA)
- …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 Officer, who will ... oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program...areas + Adequately staff and manage the program integrity investigator (s) responsible for all FWA detection programs and activities… more
- CVS Health (Sacramento, CA)
- …and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities**...known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- Tennessee Comptroller of the Treasury (TN)
- …of the Treasury is seeking an Investigator to investigate allegations of fraud , waste, and abuse in government and publicly funded entities. This will ... Fraud Investigator : Upper-East (Tri-Cities) Tennessee The...of making government work better by investigating allegations of fraud , waste, and abuse in government and… more
- Bank OZK (Fort Smith, AR)
- …and maintains professional working relationships with local law enforcement and peer bank fraud professionals. + Investigates possible elder abuse and reports to ... required. + Certification in a relevant discipline (ie, Certified Fraud Examiner-CFE, Certified Financial Crimes Investigator -CFCI, Certified Anti-Money… more
- Zurich NA (Pasadena, CA)
- Medical Provider Claims Fraud Investigator 121315 Zurich North America is hiring an Medical Provider Claims Fraud Investigator to join our team! We are ... ** + Conduct thorough investigations into medical provider cases involving potential fraud or abuse . + Collect, analyze, and interpret complex medical… more
- Fallon Health (Worcester, MA)
- …is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar in the ... Senior Director of Internal Audit in their leadership of the Fraud , Waste and Abuse (FWA) program. The FWA Manager will be responsiblefor general supervisionover… more
- CareFirst (Baltimore, MD)
- …**Education Level:** Bachelor's Degree. **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) and + Certified Expert Coder-AHIMA ... and resolution of all levels (low to complex), of fraud , waste, and abuse schemes, resulting in...fraud software analysis, and appropriately sourced reference materials. Investigator ensures timely maintenance and organization of case file… more