- Humana (Indianapolis, IN)
- …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
- The Cigna Group (St. Louis, MO)
- …+ Directly interact with multiple levels within partner organization to coordinate Fraud Waste and Abuse activities. Interactions will include meetings with ... attendees including partner Senior Managers and Directors. + Coordinate multiple investigations to...of equivalent work experience + Relevant experience as a Fraud Investigator in healthcare + Certified Pharmacy… more
- CareFirst (Columbia, 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
- Sharp HealthCare (San Diego, CA)
- …other requirements for the position, and employer business practices. **What You Will Do** The Senior Fraud , Waste and Abuse Specialist at Sharp Health Plan ... Requirements** + Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) Certification - Preferred **Essential Functions** +… more
- City of New York (New York, NY)
- …federal and state data sources. BFI is recruiting for three (3) Fraud Investigator II to function as Senior Investigators, who will: - Conduct complex ... Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR...investigations into allegations of fraud , waste , and/or abuse of social services… more
- CVS Health (Hartford, CT)
- …make health care more personal, convenient and affordable. **Position Summary:** As a Senior Investigator you will conduct high level, complex investigations of ... - Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations. **Pay Range** The typical pay range for this role… 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 ... summary of purpose:** Under the general direction of the Senior Internal Audit Manager, theAnalyze and interpret patient medical...Director of Internal Audit in their leadership of the Fraud , Waste and Abuse (FWA) program. The… more
- CVS Health (Raleigh, NC)
- …+ Conduct high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse. + Conduct Investigations to prevent payment of ... the recovery of company and customer money lost as a result of fraud , waste and abuse. + Cooperates with federal, state, and local law enforcement agencies… more
- MTA (New York, NY)
- …Location: New York City, New York Hours: Full-Time Compensation : Construction Auditor/ Investigator $81, 157 - $101, 446 Senior Construction Auditor/ ... Construction oversight staff investigat e allegations of wrongdoing or fraud and conduct proactive reviews to identify and uncover...trade and five year s of relevant experience. + Senior Construction Auditor/ Investigator : A Bachelor's degree… more
- New York State Civil Service (New York, NY)
- …OR a license in a trade and five years of relevant experience. Senior Construction Auditor/ Investigator : A Bachelor's degree (in fields such as construction ... HELP No Agency MTA Inspector General, Office of Title Construction Auditor/ Investigator Series Occupational Category Other Professional Careers Salary Grade NS… more