Healthcare Fraud Investigator & Anti-Fraud Specialist
Highmark Health
Highmark Inc. is seeking a dedicated professional to develop and maintain an anti-fraud program, conduct investigations into fraud, waste and abuse by providers and members, and coordinate with enforcement agencies. The role requires testimony in court, and the ability to lead audits and recover misappropriated funds. The candidate should have 3 years of health insurance fraud investigation experience, a related bachelor's degree, and preferred fraud-related certifications. #J-18808-Ljbffr Highmark Health
- ...as On-Call Behavioral Health Specialist I/II. This position is part... ...many individuals, families, healthcare providers, first responders,... ...employment job-related background investigation. Perform job duties in a... ...alleging irregularity, fraud and/or error in application...SuggestedPermanent employmentContract workPart timeWork experience placementWork at officeShift workNight shiftWeekend workAfternoon shift
$160k - $190k
...Healthcare Associate Attorney Sacramento, CA Direct Counsel is seeking a Healthcare Associate Attorney with 1-4... ...of medicine, Cost and Market Impact Review requirements, fraud and abuse, Stark Law, Anti-Kickback Statute, HIPAA, and other healthcare compliance...SuggestedWork at office- ...inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional... ...as possible. Position Summary : The Associate Spine Specialist will work together with the Spine Territory Manager and will have...SuggestedFull timeNight shift
$90k - $105k
...leader in infusion therapy and pain management, develops, manufactures, and markets innovative medical products and services to the healthcare industry. Other key product areas include nutrition, pharmacy admixture and compounding, ostomy and wound care, and dialysis. The...SuggestedFor contractorsSeasonal workWork at officeRemote workRelocationShift work- ...About the Position The County of Riverside's Department of Public Social Services (DPSS), Special Investigations Unit, is seeking to fill a position for the Welfare Fraud Investigator throughout the Western Region of Riverside County. This recruitment may be used for future...SuggestedDaily paidTemporary workWork at officeLocal areaRemote workFree visaMonday to FridayNight shiftWeekend work
$20k
BSA/AML Specialist x 2 - Contract - Remote - $28.00 - $32.0/hr. The final... ...- Understanding of Anti-Money Laundering (AML) compliance... ...compliance referrals - Experience investigating cash transactions - Previous financial crimes, AML, fraud, or compliance operations experience...Hourly payContract workLocal areaRemote workWork from homeVisa sponsorship- ...of our life-saving therapies. The Specialist I, Quality Assurance is an integral entry... .... Support thorough and timely investigations of deviations and assist in documenting... ...serve our team, our patients and their healthcare providers. Notice to staffing firms...Full timeLocal areaRemote work
$98k - $127k
...challenges. Our teams create exceptional design solutions for healthcare, science and technology, workplace, mixed use, higher education... ...office of SmithGroup is looking for a Senior Proposal Specialist to join our team. Working with us, you will:Proposal and Pursuit...Work experience placementWork at officeLocal area- ...services to public and private sector clients in the aviation; healthcare; education (K-12 and higher); justice and essential services;... ...nonprofit markets.Job DescriptionWe are seeking a Certified Access Specialist (CASp) to support accessibility compliance for construction...Full timeContract workFor contractorsLocal areaFlexible hours2 days per week1 day per week
- ...developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country.... ...of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and...Work experience placement
- ...than 40 years and is known throughout the healthcare industry and nationally as a leading... ...state healthcare laws (e.g., Stark Law, Anti-Kickback Statute, HIPAA, licensing, scope... ...regulatory requirements, including healthcare fraud and abuse laws, and related healthcare compliance...
$85k - $113.3k
...information, please visit What We Do Provide a central resource for fraud-tool escalations, identity-review support, property-owner... ...and works closely with other teams to complete in-depth investigations and support, wire and defalcation mitigation workflow. Assist...Local area$23.7 - $35.52 per hour
.... At Dexcom, we're more than just a medical device company; we're a collective of visionary thinkers, trailblazers, and problem solvers. Our mission transcends the ordinary. We aim to revolutionize healthcare, one groundbreaking technology at a time. #J-18808-Ljbffr...Work at officeWorldwideHome officeFlexible hours$24.9 per hour
...Health Information Specialist We are seeking a detail-oriented Health Information Specialist to support the integrity, security... ...equivalent required. Coursework in Health Information Management, Healthcare Administration, or a related field preferred. Minimum of...Contract workTemporary workWork at office$138k - $160k
...seeking a Senior Program Integration Specialist to join the integrated program management... ...assured and compliant solutions for healthcare, we understand that digital transformation... ...may be subject to a background investigation and/or education verification. SMX...Contract workWork experience placementH1bWork at office- ...Our client is a leader in providing comprehensive healthcare services to older adults through the Program of All-Inclusive Care for the... ...serve and are seeking an enthusiastic and results-driven Outreach Specialist to join their team in Sacramento, CA. As an Outreach...Base plus commission
$100k
...Remote, Nationwide – Seeking Provider Enrollment Specialist Everybody Has A Role To Play In Transforming Healthcare At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our...Daily paidFull timeContract workPart timeWork experience placementWork at officeLocal areaRemote workFlexible hours- ...and in‑person channels. You will verify eligibility, schedule appointments, and handle inquiries with accuracy, while adhering to healthcare regulations. The role emphasizes HIPAA compliance, EMR use (NextGen, Epic, eClinicalWorks), and collaboration with care teams....
- ...management Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #J-1880...Remote jobWork at office
- ...supply chain management and e-commerce. With 20,000 team members at over 100 locations, we focus on the Consumer Products, Tech, Healthcare, Automotive and Publisher industries. You will work in an environment built on collaboration, respect, commitment and curiosity,...Work at officeFlexible hours
$64k - $92.6k
Job Summary At Healthcare in Action, we serve patients experiencing homelessness through an innovative "street medicine" approach by contracting... ...field-based behavioral health experience. The Mental Health Specialist serves as the behavioral health clinician on a two-person MCRT...Temporary workRemote workShift workWeekend workWeekday work$62.4k - $106.7k
The Diagnostic System Specialist is responsible for installing and training clients on clinical diagnostic products, including system operation... ...discovery process and transforming the fields of science and healthcare. As one of the top five life science companies, we are a...Work experience placementRemote work- Boomerang Healthcare is seeking an AR Follow-Up Specialist to ensure timely and accurate follow-up of accounts receivable within the RCM department. This remote role supports California Medicare, Commercial, WC, and Rehab services, focusing on reducing DSO and improving...Remote job
$75k
Intermedia Group Inc. is seeking a Spanish Speaking Healthcare Sales Specialist (Outreach and Enrollment) to support enrollment in California. The role emphasizes outreach, relationship-building with referral sources, and guiding seniors into the PACE program. Locations...Weekend workAfternoon shift$70k - $75k
...learning, and career development. Summary As an Out-of-State Provider Specialist - Remote California at Gainwell, you will support California's Medi-Cal program by reviewing out-of-state healthcare claims, coordinating provider enrollment activities, and ensuring accurate...Remote jobFull timeWork at officeFlexible hours- All Jobs > Behavioral Health Intake Specialist The Behavioral Health Intake Specialist is the first point of contact for individuals,... ...Experience Associate’s degree or higher in psychology, social work, healthcare administration, public health, or a related field. Equivalent...Contract workWork experience placementWork at office
- ...passion for working with adults that are underrepresented in the science workforce. Job Overview: We are currently seeking a Learning Specialist. The ideal candidate is well‑versed in multiple science subjects, can quickly establish a rapport and communicate well,...Remote workWork from homeFlexible hours
- Imagen Technologies is seeking a detail-oriented Licensing Specialist to manage physician licensure applications for our rapidly growing teleradiology practice. You will work with our Credentialing and Licensing Team to maintain sensitive physician information, submit...Remote job
- Amerit Consulting is seeking a Call Center Representative for a major PBM client. The role is remote with California residency required, on a 9-month contract with potential for extension and possible full-time conversion. You will assist members, answer questions about...Remote jobFull timeContract workShift workWeekend work
- ...service training within a military medical facility. Applicants may qualify via specialized experience or education (Ph.D or 3 years of graduate study in Healthcare Administration, Public Health, or Communications). #J-18808-Ljbffr US Military Treatment Facilities under DHA
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