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...
Accredited Health Care Fraud Investigator (AHFI). ...
A company is looking for a Remote Background/Desktop Investigator. ...
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. ...
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...
Accredited Health Care Fraud Investigator (AHFI) . ...
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 pricing for subject visits, procedures, and invoiceable expenses to inform site budget negotiations. Collaborate with Clinical Operations and Investi...
Exhibits behaviors outlined in SIU Investigator Competencies. ...
In this role, the Investigator will use a variety of tools to initiate investigations, identify subjects and develop cases for future action, including a referral to law enforcement, education, over payment recovery and other administrative actions meeting all applicable client requirements. The Inv...
Investigator Contracts Lead I (ICL I) is responsible for direct site facing contract and budget negotiations through contract execution with assigned clinical investigator sites including initial agreements and amendments and oversight of other contracting professionals on assigned studies. Follow c...
The Certified Professional Coder Investigator II is responsible for performing highly complex healthcare fraud investigations including but not limited to, complex surgical operations, inpatient hospital coding including diagnostic related grouping (DRG), and anesthesia cases. The incumbent supports...
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...
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...
Architectural Historian (Principal Investigator) . ...
The Pharmacy Investigator will utilize claims data, applicable guidelines and other sources of information to identify aberrant billing practices and patterns. The Pharmacy Investigator is responsible for conducting investigations which may include field work to perform interviews and obtain records...
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,...
Investigator Field Leaders are responsible for the operational oversight of independent contractor investigators as well as part-time employee investigators, often in a widely dispersed geographic area. Investigator Field Leader provides oversight of investigator performance, quality of work product...
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,...
The Fraud Investigator I position is a key role in the Fraud Investigations Unit of the Corporate Fraud Division. ...
Certified Fire Investigator / Certified Fire & Explosion Investigator (CFI/CFEI) responsible for analyzing and interpreting fire and explosion scenes. Mentor and train subordinate investigators. Must meet all the requirements for qualification as a fire investigator per NFPA 1033. ...
Investigator Contracts Lead I (ICL I) is responsible for direct site facing contract and budget negotiations through contract execution with assigned clinical investigator sites including initial agreements and amendments and oversight of other contracting professionals on assigned studies. Follow c...
Federal EEO Investigator/32-hour certification required. The Ravens Group is seeking experienced EEO investigators to perform investigations for various Federal agencies. Investigators are responsible for all aspects of the investigation including but not limited to developing an investigative plan,...
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. ...
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...