Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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

Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Healthcare Fraud Investigator & Anti-Fraud Specialist in Sacramento, CA vacancy
  •  ...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... 
    Suggested
    Permanent employment
    Contract work
    Part time
    Work experience placement
    Work at office
    Shift work
    Night shift
    Weekend work
    Afternoon shift

    Stanislaus County

    Sacramento, CA
    1 day ago
  • $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... 
    Suggested
    Work at office

    Direct Counsel

    Sacramento, CA
    3 days ago
  •  ...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... 
    Suggested
    Full time
    Night shift

    Globus Medical

    Sacramento, CA
    4 days ago
  • $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... 
    Suggested
    For contractors
    Seasonal work
    Work at office
    Remote work
    Relocation
    Shift work

    B. BRAUN MEDICAL (US) INC

    Sacramento, CA
    21 days ago
  •  ...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... 
    Suggested
    Daily paid
    Temporary work
    Work at office
    Local area
    Remote work
    Free visa
    Monday to Friday
    Night shift
    Weekend work

    County of Riverside

    Sacramento, CA
    4 days ago
  • $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 pay
    Contract work
    Local area
    Remote work
    Work from home
    Visa sponsorship

    Hays

    Sacramento, CA
    6 days ago
  •  ...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 time
    Local area
    Remote work

    Orca Bio

    Sacramento, CA
    24 days ago
  • $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 placement
    Work at office
    Local area

    SmithGroup

    Sacramento, CA
    2 days ago
  •  ...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 time
    Contract work
    For contractors
    Local area
    Flexible hours
    2 days per week
    1 day per week

    Vanir

    Sacramento, CA
    1 day ago
  •  ...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

    Qlarant

    Sacramento, CA
    2 days ago
  •  ...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... 

    GRP SCAN Group

    Sacramento, CA
    3 days ago
  • $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

    First American

    Sacramento, CA
    2 days ago
  • $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 office
    Worldwide
    Home office
    Flexible hours

    1 DexCom Inc

    Sacramento, CA
    12 hours ago
  • $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 work
    Temporary work
    Work at office

    Actalent

    Sacramento, CA
    1 day ago
  • $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 work
    Work experience placement
    H1b
    Work at office

    SMX Corporation

    Sacramento, CA
    2 days ago
  •  ...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

    Pursuit

    Sacramento, CA
    3 days ago
  • $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 paid
    Full time
    Contract work
    Part time
    Work experience placement
    Work at office
    Local area
    Remote work
    Flexible hours

    MedAmerica, Inc.

    Sacramento, CA
    4 days ago
  •  ...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.... 

    La Maestra

    Sacramento, CA
    3 days ago
  •  ...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 job
    Work at office

    Molina Healthcare Inc

    Sacramento, CA
    3 days ago
  •  ...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 office
    Flexible hours

    Bertelsmann

    Sacramento, CA
    2 days ago
  • $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 work
    Remote work
    Shift work
    Weekend work
    Weekday work

    HIAMS Healthcare in Action, Inc

    Sacramento, CA
    3 days ago
  • $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 placement
    Remote work

    Bio-Rad Laboratories

    Sacramento, CA
    4 days ago
  • 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

    Integrated Pain Management Medical Group, Inc.

    Sacramento, CA
    3 days ago
  • $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 work
    Afternoon shift

    Intermedia Group Inc.

    Sacramento, CA
    12 hours ago
  • $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 job
    Full time
    Work at office
    Flexible hours

    Gainwell Technologies

    Sacramento, CA
    2 days ago
  • 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 work
    Work experience placement
    Work at office

    South Coast Community Services

    Sacramento, CA
    3 days ago
  •  ...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 work
    Work from home
    Flexible hours

    Back On Course Educational Services LLC

    Sacramento, CA
    2 days ago
  • 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

    Imagen Technologies

    Sacramento, CA
    3 days ago
  • 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 job
    Full time
    Contract work
    Shift work
    Weekend work

    Amerit Consulting

    Sacramento, CA
    4 days ago
  •  ...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

    US Military Treatment Facilities under DHA

    Sacramento, CA
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Healthcare Fraud Investigator & Anti-Fraud Specialist. Be the first to apply!