As a Fraud Investigator, you will investigate and research cases of identified fraud, fraud loss, or suspicious events to identify fraud rings and patterns, assist victims in resolving fraud events, and denying fraud claims identified as false through investigation. A primary responsibility of a fra...
With increasing independence, the Investigator II is assigned to multiple provider types and serves as a senior investigator in the Unit. The Investigator II will coach other investigators on developing techniques to find provider schemes based on federal and state regulations that govern Medicaid. ...
The Senior Investigator is responsible for identification, investigation and prevention of healthcare fraud, waste and abuse. The Senior Investigator will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The Senior Inves...
A company is looking for a Remote Background/Desktop Investigator. ...
Ensures hospital billing integrity for healthcare system by accurately reviewing, researching, analyzing, and validating credit balances within Epic HB Resolute.Responsible for credit balance resolution by processing refunds for third party payers and patients, payment transfers, charge corrections,...
Exhibits behaviors outlined in SIU Investigator Competencies. ...
Ensures hospital billing integrity for healthcare system by accurately reviewing, researching, analyzing, and validating credit balances within Epic HB Resolute.Responsible for credit balance resolution by processing refunds for third party payers and patients, payment transfers, charge corrections,...
As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through. This is not a physical investigator role. Preferred certifications:Accredited Healthcare Fraud Investigator (AHFI),Certified Fraud Specialist (CFS),Certified Fraud Examiner (CFE),Certifie...
This position partners with Global Clinical Operations (GCO), Investigator Contracts Management (ICM), and Data Management teams to establish clinical pricing for subject visits, procedures, and invoiceable expenses to inform site budget negotiations. Collaborate with Clinical Operations and Investi...
Qlarant has an immediate opening for a UPIC West Healthcare Fraud Lead Investigator to provide supervision and mentoring to a team of Investigators. Supervises intake investigators and/or investigators and assigns work; regularly reviews team’s leads in screening and/or investigations and acti...
You could be the one who changes everything for our 28 million members.Centene is transforming the health of our communities, one person at a time.As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Investigate al...
Worldwide Clinical Trials (Worldwide), a leading global contract research organization (CRO), works in partnership with biotechnology and pharmaceutical companies to create customized solutions that advance new medications – from discovery to reality.Anchored in our company’s scientific heritage, ou...
The Special Investigator develops and implements strategies and tactics to prevent and reduce fraud as well as the identification, investigation and prosecution of all fraudulent activities. ...
As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through. This is not a physical investigator role. Preferred certifications:Accredited Healthcare Fraud Investigator (AHFI),Certified Fraud Specialist (CFS),Certified Fraud Examiner (CFE),Certifie...
People Relations (“PR”) is a department comprised of a team of seasoned investigators located in the US, EMEA and LATAM. The Investigator role personally conducts employment investigations involving employees across all business units. The investigator role investigates and resolves employment-relat...
To use a variety of undercover investigative methods to conduct field investigations in PETA's focus areas, including the use of animals for food, clothing, experimentation, and entertainment.Primary Responsibilities and Duties:.Travel to different states and temporarily stay on location for various...
ESSENTIAL DUTIES AND RESPONSIBILITIES.The associate is responsible for the functions below, in addition to other duties as assigned:.Investigate and resolve external theft (Shoplifting, Organized Retail Crime, etc.Gathers, analyzes, and evaluates intelligence on individuals and groups involved in or...
Principal Investigator (Terrestrial Archaeology – Southwest). ...
The Investigator should demonstrate proficiency in the following areas: Must be motivated and possess a strong work ethic Must be customer service driven Able to format/type/edit full reports of background research findings Proficient with Microsoft Word and Microsoft Outlook Ability to take directi...
This role will report to Head of Investigation, Claim in implementing field check with client’s family or neighbor to very information, checking document requirement, prepare pending letter/payment letter/declined letter and follow up progress of implementation.Check document requirement, prepare pe...
This position partners with Global Clinical Operations (GCO), Investigator Contracts Management (ICM), and Data Management teams to establish clinical costing for subject visits, procedures, and invoiceable expenses. Under guidance, collaborate with Clinical Operations and Investigator Contracts Man...
Investigates complaints regarding alleged violations of the Nurse Practice Act and apply knowledge throughout the investigatory process to determine violations and risks to public safety. Extracts and analyzes information from statutes, legal documents, evaluations, healthcare and employment related...
Certified Fire Investigator / Certified Fire & Explosion Investigator (CFI/CFEI) responsible for analyzing and interpreting fire and explosion scenes. Must meet all the requirements for qualification as a fire investigator per NFPA 1033. ...
TMB - Investigator V (REMOTE)(00042167). Job Title:Field Investigator – Licensed LVN or RN. Ability to explain and interpret pertinent provisions of laws and regulations to other investigators, licensees, and complainants. Job Title:Field Investigator – Licensed LVN or RN. ...
As a Suspicious Activity Report (SAR) Investigator for high-risk typologies, you will conduct investigations, analyze transaction activity and trends, as well as write and review SARs. ...