Senior FWA Investigator - Healthcare Claims & Compliance
$46.99k - $112.2kHispanic Alliance for Career Enhancement
Hispanic Alliance for Career Enhancement is seeking a Sr. Analyst for Fraud, Waste, and Abuse to support healthcare service investigations. This position includes reviewing claims data and coordinating investigations with regulatory agencies. Candidates should have experience in coding guidelines and analytical skills. This full-time role offers a salary range of $46,988.00 - $112,200.00, along with comprehensive benefits. #J-18808-Ljbffr
$74.7k - $187k
...Job Description We are seeking a Product Manager to drive the expansion of Oracle's healthcare claims adjudication platform for the United States market. Our existing platform supports healthcare claims processing across multiple international markets. This role...SeniorClaimsTemporary workFlexible hours$46.99k - $122.4k
...disciplinary provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc.... ...agencies in the investigation and prosecution of healthcare fraud and abuse matters. Demonstrates high level of...SeniorClaimsHourly payFull timeTemporary workLocal area$23 per hour
...Job Description Job Description Overview Company Overview: Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in...ClaimsWork experience placementWork at officeLocal area- ...A risk management firm is seeking a Senior Account Captive Manager to oversee a portfolio... ...relationships, ensuring regulatory compliance, and facilitating audits and board meetings... ...considerable experience in client coordination or claims management, with strong communication...SeniorClaims
$90k - $115k
...Description Medicaid NEMT Compliance Officer Job... ...providing exceptional healthcare transportation experiences... ...fraud, waste, and abuse (FWA), and maintenance of... ...Responsibilities include auditing, investigating, implementing training... ...: Monitors transport claims for accuracy, ensuring...Claims$67.9k - $199.14k
...an exciting opportunity for a Senior Informatics Manager to join... ...analytics, interpreting large healthcare datasets, and translating findings... ...medical and pharmacy claims, encounter, provider, and membership... ...stakeholders Support compliance with CMS and state Medicaid requirements...SeniorClaimsHourly payFull timeTemporary workWork experience placementLocal areaRemote work$82.5k - $209.5k
...to help define and drive Oracle Health’s healthcare payer strategy in the United States.... ...healthcare payer solution domains, including claims adjudication, prior authorization... ...management skills. Experience engaging with senior leaders and executive decision-makers...ClaimsContract workTemporary workFlexible hours$150.03k - $224.25k
...strategy, planning and execution of global investigational and marketed prescription drug... ...Experience working in the pharmaceutical and/or healthcare industry. Knowledge and experience... ...application processing fee, even if claimed you will be reimbursed, this is not Otsuka...SeniorClaimsTemporary workWork at officeLocal areaFlexible hours$91.4k - $187k
...Oracle Health is transforming healthcare through intelligent,... ...seeking a highly motivated Senior Product Manager to lead product... ...data science, UX, architecture, compliance, operations, and commercial teams... ...with prior authorization, claims management, eligibility verification...SeniorClaimsTemporary workWorldwideFlexible hours$124.4k - $207.4k
...The Senior Manager, IIS Prostate Cancer Strategy & Forecasting is a key strategic partner to the US Prostate Cancer franchise and Talzenna... .... Ability to manipulate large data sets, e.g., commercial claims data, using modern analytic tools, including Snowflake SQL Comfort...SeniorClaimsPrice workPermanent employmentTemporary workH1bLocal areaVisa sponsorshipWork visaRelocation package2 days per week3 days per week$91.4k - $187k
...Health is seeking an experienced Senior Product Manager to support... ...software development in healthcare IT, including concepts related... ...Experience with prior authorization, claims management, eligibility... ...including HIPAA and related compliance frameworks. Experience launching...SeniorClaimsTemporary workFlexible hours- ...Old Harbor Solutions, is looking for a Senior Analyst/Site Lead in Williston, VT. The... ...supervising contractor personnel, ensuring compliance with government policies, and managing... ...have over five years of experience in investigations and a deep understanding of immigration...SeniorFor contractors
$145k - $165k
...Position Overview The Compliance Manager is a member... ..., including healthcare compliance, anti-corruption... ...Anti-Kickback, False Claims Act, HIPAA, Anti-Corruption... ...Department on Investigations and Policy Audit.... ...risks to colleagues and senior management. Demonstrated...ClaimsRemote workFlexible hours- ...A national investigative services leader is seeking experienced SIU Field Investigators in Montpelier, VT. This part-time role offers flexible hours and competitive pay for those with SIU/Claims investigation experience. Responsibilities include conducting investigations...ClaimsPart timeFlexible hours
- ...NuHarbor Security is looking for a Senior Security Analyst to join their team in Burlington, VT. This senior-level position demands... ...cybersecurity, especially within SOC operations. You will lead investigations, mentor junior analysts, and produce documentation for client...Senior
- ...Northeast. Directly handle a diverse claims caseload including multiple coverage... ...RESPONSIBILITIES Conduct and coordinate loss investigations on all assigned claims. Negotiate... ...of all files handled inclusive of MSP compliance. Provide accurate, courteous and...SeniorClaimsContract workWork at officeRemote workNight shift
$25 - $32 per hour
...national leader? Join Lemieux & Associates , a trusted leader in investigative services, and make an impact with your surveillance expertise.... ...as a private investigator conducting surveillance. SIU/Claims investigation experience ( preferred ). Bilingual skills (...ClaimsPart timeFlexible hours$25 - $30 per hour
...national leader? Join Lemieux & Associates , a trusted leader in investigative services, and make an impact with your surveillance expertise.... ...for professional growth. Requirements Must have SIU/Claims investigation experience as a Private Investigator or Fraud Investigator...ClaimsHourly payPart timeLive inFlexible hours- ...The Jonus Group is looking for a Senior Workers’ Compensation Claims Adjuster to join their team, fully remote, supporting a dedicated Vermont account. The ideal candidate will have over 5 years in claims adjusting, strong knowledge of Connecticut regulations, and the...SeniorClaimsRemote work
- ...Employment Specialists Ltd in Colchester is seeking an experienced Claims Handler to manage a variety of Liability claims. This role involves assessing claims, conducting investigations, and negotiating settlements with solicitors. Ideal candidates will have strong analytical...SeniorClaimsWork at office
$88.3k - $187k
...Job Description Senior Human Factors Researcher Location: Austin TX Visa sponsorship... ...reach to redefine what’s possible in healthcare. This isn’t just a career—it’s an... ...established usability and safety goals. Lead investigations of complex and dynamic interactions...SeniorTemporary workLocal areaRemote workFlexible hours$60k - $80k
...A leading insurance provider is seeking a Sr. Field Claims Representative in Barre, Vermont. This field-based position involves investigating and settling claims for both personal and commercial property. The ideal candidate will have 5-7 years of experience in handling...SeniorClaims$89k - $121.4k
...Become a part of our caring community The Senior Business Intelligence Engineer builds... ...Visual Studio Experience with healthcare systems and prior authorization data... ...of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act...SeniorFull timeTemporary workApprenticeshipRemote work- ...Itlearn360 is seeking a Property Claims Field Adjuster located in Burlington, VT. This role involves investigating and settling homeowner and commercial property claims with a focus on possible fraud. The ideal candidate will have 5-7 years of experience in property claims...Claims
$150.03k - $224.25k
...of Clinical Management, the Senior Clinical Study Manager is responsible... ...IRB, IVRS, etc.), and investigative sites. • Provide... ...investigative sites to maximize compliance with study protocol. • Provide... ...processing fee, even if claimed you will be reimbursed, this...SeniorClaimsContract workTemporary workLocal areaFlexible hours- ...billing services to our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve... ...coded in a timely fashion, and for optimum reimbursement and compliance. Ensure that all claims reach the payers, and independently...ClaimsPrivate practiceLocal areaRemote work
$70 - $90 per hour
...passionate team of mental health advocates and healthcare veterans, Grow is looking for providers... ...credentialing, billing, and insurance claims so providers can enjoy the freedom of... ...will be a strong mutual fit. Seniority level ~ Seniority level Mid-Senior level...ClaimsContract workPrivate practiceRemote workWeekend workAfternoon shift$46.99k - $112.2k
...and Prescriber behavior to effectively pursue the prevention, investigation and prosecution of Fraud Waste and Abuse. Collaboration with... ...Qualifications 3-5 years investigative experience in the area of Healthcare and Pharmacy fraud, waste and abuse. Knowledge of Pharmacy...SeniorHourly payFull timeTemporary workWork experience placementWork at officeLocal area$70.6k - $141.2k
...technologies that support clinicians, inspire innovation, empower patients, and save lives. Our mission? To create a human-centric healthcare experience powered by unified global data. It’s a big challenge, but big challenges are what we do best. We’re already...SeniorTemporary workFlexible hours$102k - $120k
...data collaboration platform trusted for healthcare. Guided by our mission to make the world... ...services such as IT, HR, Finance, Legal/Compliance, and overall Executive and Corporate activities... ...strategic and analytically rigorous Senior Financial Analyst to join our team. This...Senior
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