Fraud Investigator & Anti-Fraud Program Specialist
Highmark Health
Highmark Inc. is seeking an experienced anti-fraud professional to develop and maintain a comprehensive fraud program. You will conduct investigations across providers, members, facilities, and vendors, prepare cases for law enforcement, and help ensure regulatory compliance through audits and reporting. The role requires strong analytical, communication, and interview skills, with fieldwork and testimony in court as potential duties. This position is office-based with periodic travel as needed. #J-18808-Ljbffr
- ...Highmark Inc. is seeking an experienced anti-fraud investigator to develop and maintain an anti-fraud program, conduct investigations, and coordinate with law enforcement and regulators. The role includes field investigations, testifying in court, and ensuring compliance...Suggested
$65k - $88.6k
Become a part of our caring community The Fraud and Waste Professional is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving South Carolina's Medicaid Program. The Fraud and Waste Professional coordinates investigation...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$138k - $160k
SMX is seeking a Senior Program Integration Specialist to join the integrated program management office (PMO) supporting multiple contracts, task... .... Selected applicant may be subject to a background investigation and/or education verification. SMX does not sponsor a new...SuggestedContract workWork experience placementH1bWork at office$46.99k - $112.2k
...Dental Fraud InvestigatorWe're building a world of health around... ...effectively pursue the prevention, investigation and prosecution of Fraud,... ...the National Health Care Anti-Fraud Association (AHFI)Bilingual... ...or short-term incentive program in addition to the base pay range...SuggestedHourly payFull timeTemporary workLocal area$62.7k
...This job is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing... ...and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged...SuggestedContract workFor contractorsWork at officeLocal area- ...of Mental Health is currently seeking Associate Mental Health Specialists on Night Shift. Associate Mental Health Specialists will be given... ...Low cost group life insurance Incentive-based Wellness Program Qualified Employer for Public Service Student Loan Forgiveness...Work experience placementFlexible hoursShift workNight shift
$125k - $135k
...The Advanced Specialist, Project Management drives the planning, execution, and delivery of strategic initiatives across multiple squads... ...distributed onshore and offshore workforce. It leads through program-management expertise, technical fluency, and influence without...Full timeRemote work- ...complete setup, operation, and first-article verification on horizontal, vertical, and 5-axis mills. You will work from drawings, CAM programs, and setup sheets, selecting fixtures, loading tools, editing G-code, and verifying offsets to deliver conforming parts on...
$27.3 - $35.01 per hour
...deployment of policies, procedures and programs designed to minimize risk, enable compliant... ...chain integrity. Job Summary The Specialist, Quality Compliance supports the... ...activities, process improvements, and investigations to develop knowledge and process of applicable...Hourly payFull timeTemporary workWork experience placementLocal areaImmediate startRemote workFlexible hours$68.5k - $88k
...ensure quality outcomes, and elevate patient care. The Senior Specialist, Product Marketing will play a critical role in supporting... ...speaking with customers and sales teams, as a product/program expert, as well as serving as a key point of coordination to support...Full timeContract workTemporary workWork experience placementWork at officeLocal areaRemote workWork from homeFlexible hours$80k - $90k
...Marketing, ABM, & Growth to help bring our products to market, strengthen how we communicate their value, and develop targeted marketing programs that drive awareness, engagement, and growth. This role will primarily focus on product marketing and account-based marketing (ABM...Full timeRemote work$24 - $27 per hour
...integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you’ll consider joining our growing team of uniquely talented...Ongoing contractWork experience placement$31.01 - $48.84 per hour
...Full time R186632 Job Description The Strategic Sourcing Specialist is responsible for collaborating with internal stakeholders... ...caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses...Hourly payFull timeContract workWork at officeRemote workRelocation$41.86k - $127.46k
...dental and other insurance plans, a generous annual and sick leave program, and participation in the Thrift Savings Plan, a retirement plan... ...of persons, documents or goods for criminal activity, fraud, and/or illegal operations. Utilizing observational techniques,...Full timeContract workWork at officeLocal areaImmediate start$51.63k - $124.72k
...plans, a generous annual and sick leave program, and participation in the Thrift Savings... ...Proficient in the use of firearms, preparing investigative reports, serving court orders (e.g.,... ...official Leading investigations of fraud, contraband, criminal activity, threats...Full timeWork experience placementImmediate startNight shift$14.42 - $20.4 per hour
...Contributions Starting Day One Medical, Dental, & Vision Insurance with Optional Flexible Spending Account (FSA) Team Member Health/Wellbeing Programs Tuition Educational Assistance Programs Opportunities for Career Growth O'Reilly Auto Parts is an equal opportunity employer. The...Hourly payMinimum wageLocal areaImmediate startFlexible hours$14.42 - $20.4 per hour
...premiums may apply if applicable criteria are met. The Parts Specialist will provide all retail and installer customers with a high level... ...JOB FUNCTIONS Follow and promote all company customer service programs, i.e. Hi-5, Low Price Guarantee, Rock the Call, Related...Hourly payMinimum wageLocal areaFlexible hours$27.02 per hour
...Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA),... ...Coder (CPC) Certified Risk Coder (CRC) Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) Preferred...For contractorsWork at officeLocal areaRemote workFlexible hours- ...Insurance Adjusting, Construction or Home Appraisals is a plus. Experience using CAD, Rapid Sketch, Xactimate or another diagramming program will be helpful. As a Field Consultant, you will be responsible for scheduling and conducting on-site High Value Property...For contractorsWork from homeHome officeFlexible hours
$57.38k - $84.15k
...Annuity Compliance Analyst - Special Investigative UnitAddison, TX; Montpelier, VTCome... ...and respond to moderate and varied fraud referrals and perform anti-money laundering ("AML")... ...Life's discretionary annual incentive programs, subject to the rules governing such...Hourly payWork experience placementWork at officeFlexible hours- ...Office of Administration (OA) propels that mission by giving HUD programs what they need to work faster, smarter, and better. Imagine a... ...title of this position is Supervisory Government Information Specialist. As a Supervisory Privacy Specialist, you will: Plan, manage,...Full timeTemporary workPart timeWork experience placementWork at office
$80.8k - $101k
...compliance teams and play a key role in implementing and executing RxBenefits compliance vision. The ideal candidate will have strong program and project management skills and high attention to detail with the ability to multi-task. Essential Job Responsibilities Include:...Temporary workRemote work$126k - $158k
...teams? Join WWT today! Job Summary The Forward Deployed Specialist is the builder on the ground for WWT's Physical AI engagements... ...Vision Care, Onsite Health Centers (MO & IL), Employee Assistance Program, Wellness program Financial Benefits: Competitive Pay,...Full timeFlexible hoursShift work- Webb Property Inspections is seeking a Home Inspector to assess residential and commercial properties, identify defects, and provide clear written reports. You will inspect electrical, plumbing, HVAC, roofing, and other systems, use specialized tools, and communicate...Weekly payRemote workWork from homeFlexible hours
- ...Fair Hearing Specialist - Limited ServiceThe Economic Services Division (ESD) is responsible... ...response to the organization's needs, program changes, special project needs, and... ...Fair Hearing Specialist (FHS) conducts investigative research on public assistance cases escalated...Work at officeFlexible hours
$138.9k - $191k
...Advantage rules and regulations and related health care fraud and abuse laws, including the Anti-kickback statute and False Claims Act; Drafting... ...Qualifications: Demonstrated knowledge of Medicare Advantage program Demonstrated knowledge of risk adjustment and the...Full timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome office$20 - $22 per hour
...Visitor Center Specialist Waterbury Center, Vermont, United States The Green Mountain Club (GMC) is a non-profit organization with the... ...events as needed; opportunity to develop and lead educational programing. Qualifications: excellent customer service skills; computer proficiency...Hourly payLocal areaFlexible hoursWeekend work3 days per week1 day per week$35.9 per hour
...procedures. Temporary assumption of patrol commander, special investigator, training instructor, or special unit roles may be required. Periodic... ...the Vermont State Police Post-Basic Academy, Field Training Program and satisfactory completion of the one year probationary...Full timeTemporary workFlexible hoursShift workNight shiftWeekend workAfternoon shift- ...Carrington Mortgage Services is seeking a Sr. Escrow Oversight Specialist to manage escrow processes for loans with mortgage insurance and ensure timely reconciliation of FHA/PMI/USDA payments. This role requires experience with FiServ, Encompass, and related tools, plus...Remote work
$26.47 - $43.62 per hour
US Postal Service is hiring for a Postal Mail Processor. No experience required; paid training is provided. This entry-level role offers a starting wage of $26.47 to $43.62 per hour with an annual average around $72,400, plus comprehensive benefits including medical and...Hourly pay
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