Healthcare Audit & Compliance Investigator
NACBA
CVS Health is seeking a Program Integrity Auditor to review medical and other healthcare records for proper coding and documentation, with focus on regulatory standards and potential fraud, waste or abuse. Responsibilities include audits across Medicaid lines and coordination of reports for stakeholders. The role requires professional coder licenses and 3–5 years in claims review, with a full-time schedule and comprehensive benefits. On-site work is expected in the U.S. #J-18808-Ljbffr NACBA
- Centene Corporation is seeking a clinical compliance investigations professional to lead enterprise-wide investigations for all business units and health plans. You will manage case intake, interviews, fact-finding, and reporting, ensuring adherence to policies and regulatory...SuggestedRemote job
$70.1k - $126.2k
...Under the general direction of the VP of Compliance Investigations this position assists with the... ...years of experience in investigations, auditing and risk analysis required. 1+ year of... ...compliance investigations in a regulated healthcare environment preferred. Experience...SuggestedFull timePart timeWork at officeRemote workFlexible hours$127.2k - $246.9k
...work and build a career, KPMG provides audit, tax and advisory services for organizations... ...a Manager, Personnel Background Investigations to join our Enterprise Security Services... ...experienceDemonstrated knowledge of relevant compliance obligations such as Fair Credit...SuggestedH1bWork at officeLocal area$150k - $240k
...complex regulatory landscapes with ease. We ensure proactive compliance with key environmental laws, including the National Historic... ...and the National Environmental Policy Act. As the Principal Investigator you will plan, oversee, and support cultural resources...SuggestedFull timeWork at officeLocal areaRemote workFlexible hours- ...assignment based in Overland Park, KS, with potential movement to Allentown, PA depending on workload. You will investigate policy violations, privacy concerns, and compliance matters under guidance from senior investigators. Daily work includes gathering data from internal...Suggested
$18 - $22 per hour
A leading frozen dough manufacturer in De Soto, Kansas is seeking a Quality Assurance Technician to ensure compliance with food safety standards. The ideal candidate will have 3 years of QA experience in food manufacturing, proficiency in SQF/BRC systems, and excellent...Hourly payFull timeAfternoon shift- 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 insurance claim investigation. As a global leader, we...Full timeWork at officeLocal area
- Blue KC’s Special Investigations Unit seeks a Fraud Investigator to conduct reviews identifying fraud, waste and abuse, with cases of moderate complexity and limited oversight. You will perform risk assessments, use data analytics, monitor hotlines, coordinate subpoenas...
- Blue Cross and Blue Shield of Kansas City is seeking a Fraud Investigator in its Special Investigations Unit to identify potential fraud, waste, and abuse in claims with moderate complexity and limited oversight. You will assist in FWA risk assessments, monitor hotlines...
- The FBI invites healthcare professionals to transition into the role of a special agent. This move leverages... .... With specialized training and real-world investigative experience, you’ll sharpen your clinical research and compliance skills, collaborate with elite professionals,...Work at office
- ...in the United States is seeking an experienced investigator to independently lead complex fraud, waste,... ...have a Bachelor's degree in a related field, 4+ years in healthcare investigations, and experience coordinating with Compliance, #J-18808-Ljbffr Centene CorporationRemote job
- The State of Missouri’s Division Of Workers’ Compensation / Fraud And Noncompliance Unit seeks a Senior Non-Commissioned Investigator to conduct investigations into workers’ compensation fraud and noncompliance. The role involves interviewing suspects, victims, and witnesses...Work at officeNight shift
- ...company has grown to 500 employees and we currently operate in 32 states. We are a leading provider of Property & Casualty and Premium Audit information services. Company Description Headquartered in Hopkins, MN, Information Providers, Inc. (IPI) began business back...Part timeFor contractorsFlexible hours
- Physician - Academic Rheumatologist and/or Investigator Job ID: R-29939 Job Type: Full time Location: Kansas City, Missouri The University... .... The University of Kansas Health System is the official healthcare provider for the Kansas City Chiefs, Kansas City Royals, KC Current...Full time
- ...Providers, Inc. in Kansas City is hiring a full-time Insurance Premium Auditor. This role includes conducting both in-person and virtual audits, reviewing financial records, and preparing detailed reports. The position offers flexibility in scheduling and a comprehensive...Full timeFlexible hours
- About the EXL Insurance Premium Audit Group A leader in the field, EXL can complete all levels of premium audits on all auditable... ...physical and remote audits of insured’s business. Interviews, investigates, collects, and records information to be used in a written report...Remote jobHourly payWork at officeWork from homeWorldwide
- Information Providers Inc. in Kansas City is hiring a full-time Insurance Premium Auditor. You will travel to client sites to perform audits, reviewing payroll and financial records and documenting findings. The role offers a competitive salary and comprehensive benefits....Remote jobFull timeMonday to FridayFlexible hours
$42k - $55k
...client appointments. You will conduct both in‑person and virtual audits, carefully reviewing payroll records, financial documents, and... ...data. You will analyze information to ensure accuracy and compliance with insurance standards, all while staying organized and efficient...Full timeTemporary workLive inMonday to FridayFlexible hours- ...educate on fraud topics. You will open and prep fraud cases, escalate to supervisors when needed, and support the first line of defense while ensuring regulatory compliance across units. Strong analytical and communication skills are essential. #J-18808-Ljbffr Jobtailor
- A leading insurance audit company based in the United States seeks an experienced Elite Premium Auditor. This advanced role involves conducting physical and remote audits of businesses, interviewing clients, and providing detailed reports to insurance carriers. Applicants...Remote jobHourly payWork from home
- ...business units to understand the alerted activity and ensure compliance with laws. Meet scheduling and time tracking expectations to... ...Requirements One to three years of experience in fraud, banking, investigative work, or a related field preferred. Associate's degree or...Work experience placementWork at office
$66 per hour
...testing, and collaboration with interdisciplinary teams. The ideal candidate will have over 5 years of research experience, particularly in healthcare settings. Compensation is $66 per hour, and the position is eligible for various company benefits. #J-18808-Ljbffr...Hourly payPart timeRemote work$156.6k - $266.7k
...is a 1099 Independent Contractor position.* The Principal Investigator (PI) is responsible for conducting objective clinical... ...Additionally, the PI is responsible for the direction and oversight of compliance, financial, personnel and other related aspects of the...Temporary workFor contractorsWork at officeImmediate startFlexible hours- The University of Kansas Medical Center is seeking a full-time Clinician Scientist in Psychiatry and Behavioral Sciences, focused on research and behavioral interventions for cancer survivors. This position involves significant research responsibilities (75%), with clinical...Full time
$89.25k - $115.5k
...motivated and experienced professional to join the Equities Investigations team. The Sr. Investigator performs independent, specialized... ...experience in the securities industry, regulatory environment, compliance, or a related legal/investigative fieldDemonstrated experience...Full timeImmediate startFlexible hours$32.93 - $49.4 per hour
Johnson County Government is hiring a Disease Investigator RN for their Health & Environment Department in Olathe, Kansas. The role involves providing nursing services, educating patients, and managing health cases. Applicants must have a valid RN license in Kansas and...Hourly pay- ...Description Johnson County Health & Environment department is looking for a qualified candidate to fill the position of a Disease Investigator RN. The position is located at 11875 S Sunset Drive, Suite 300, Olathe, KS 66061. This position provides excellent benefits,...
- Jocogov is seeking a Disease Investigator RN in Olathe, Kansas, to provide comprehensive nursing services, conduct health assessments, and manage patient care. The role involves educating patients and providing case coordination. Successful candidates will need a Registered...
- ...The Jackson County Medical Examiner's Office is seeking a qualified investigator to join our team and handle investigations of deaths within the jurisdiction. You will document findings with accurate statements to support determinations of cause of death and perform on...Work at office
- ...preparation of manuscripts for publication and compiling grant submissions, as well as other documentation necessary for laboratory compliance. Establish and follow laboratory quality control and quality assurance policies and procedures, including appropriate...Hourly payFull timeWork at officeImmediate startWeekend workAfternoon shift
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