Clinical FWA Investigator - Medical Records & Compliance
Excellus BCBS
A major healthcare organization is seeking a Clinical Investigator responsible for thorough investigations of potential fraud, waste, and abuse in healthcare. You will conduct audits, prepare reports, and collaborate with various agencies to ensure compliance with relevant regulations. Ideal candidates should possess a current New York State RN license, significant experience in investigations, and excellent communication skills. This role promises a competitive salary range and opportunities for professional growth. #J-18808-Ljbffr Excellus BCBS
$62.4k - $96.08k
...for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of business.... ...allegations of FWA while adhering to compliance and regulatory requirements.... ...clinical reviews of medical records to ensure correct billing of...SuggestedContract workWork at officeLocal area- A renowned medical university in New York is hiring an Ethics Analyst/Auditor to support... ...for conflicts of interest, conducting investigations, and assisting with policy updates. The... .... Preferred qualifications include compliance certifications and an understanding of...SuggestedFull timeMonday to Friday
- SUNY Upstate Medical University is seeking an Ethics Analyst/Auditor to support the Integrity Officer in promoting adherence to ethical... ...Preferred qualifications include certification in healthcare compliance and experience in an academic medical institution. The...SuggestedMonday to Friday
$54k - $103k
...a Claims Manager to handle commercial claims with moderate to high complexity. This role includes investigating claims, interacting with clients, and ensuring compliance with insurance regulations. Ideal candidates will have a Bachelor’s Degree and at least four years...Suggested$50 per hour
...Nursing Home Surveyor/Complaint Investigator - Syracuse, NY (#25304)... ...We partner with hospitals, clinics, nursing homes, multi-specialty... ...investigations, ensuring compliance with federal and state regulations... ..., claims adjudication, medical review, fraud investigation,...SuggestedHourly payPermanent employmentFull timeTemporary workPrivate practiceWork at officeImmediate startMonday to FridayFlexible hours- Bechtel Corporation is seeking an Incident Investigator in Clay, NY to conduct comprehensive... ...and environmental incidents, ensuring compliance with Bechtel standards and regulatory requirements... ...a robust benefits package including medical, dental, and 401(k) with matching. Join...
$39 per hour
...Nursing Home Surveyor/Complaint Investigator - Syracuse, NY (#25311)... ...We partner with hospitals, clinics, nursing homes, multi-specialty... ..., ensuring regulatory compliance, and investigating complaints... ...of clinical experience in a medical facility, preferably a nursing...Hourly payPermanent employmentFull timeTemporary workPrivate practiceWork at office$39 per hour
...Dietitian \- Nursing Home Surveyor/Complaint Investigator - New York, NY (\#25143) Minimum of 2 years clinical experience in a medical facility, preferably a nursing home... ...nursing homes (long-term care) to determine compliance with Federal and State regulations. Produce...Permanent employmentTemporary workPrivate practiceWork at officeImmediate startFlexible hours- ...As a Assistant Investigator, you will be responsible for assisting investigative teams and supporting case work, including: assist lead... ...conduct interviews and take statements. maintain confidential records. organize evidence and case materials. work closely with law enforcement...
$25 - $30 per hour
Come grow with us! Lemieux & Associates, a national leader in the investigative industry, is seeking experienced Field Investigators in the Syracuse, NY or surrounding area. This is a part‑time position for the right individual. The owners are entrepreneurial, experienced...Hourly payPart timeWork at office- ...location of the position. Duties Conduct investigations to ensure compliance with the CSA and its implementing... ..., distribution, security, and record‑keeping activities of the pharmaceutical... .../maintain a security clearance. Medical examination. Polygraph examination...Local areaRelocationTrial period
- ...highly motivated Part‑Time Surveillance Investigators that would like to join our team of professionals... ...’s license with an acceptable driving record in accordance with the firm’s guidelines... ...business expenses. VRC also offers medical, dental, vision, disability benefits, as...Bi-weekly payHourly payPart timeWork at office
$25 - $30 per hour
Launch Your Career as an SIU Investigator Turning Your Degree Into Real-World Impact Graduated and ready for something more than a desk... ...claimants, witnesses, and involved parties Obtain written and recorded statements Identify inconsistencies and detect fraud patterns...Hourly payWeekly payImmediate startRemote workFlexible hours$25 - $30 per hour
A national investigative firm is looking for experienced SIU/Claims Investigators in the Syracuse area. This is a part-time position, with... ...obtaining statements. Benefits for full-time positions include medical, dental, and paid vacation. Competitive pay ranges from $25 to...Hourly payFull timePart time$25 - $30 per hour
Lemieux & Associates in Syracuse, NY is hiring entry-level Special Investigations Unit (SIU) Investigators. This role offers an exciting start to your career, allowing you to conduct in-depth investigations into insurance claims, interview relevant parties, and work in...Remote jobHourly pay- ...photographic documentation of subjects. Prepare and file comprehensive investigative reports using the information that was collected from... ...system. Conduct scene investigations, interviews, recorded statements, etc. Prepare written and recorded Statements from...Hourly payPart timeNight shiftAfternoon shift
$39 per hour
...Nursing Home Surveyor/Complaint Investigator - Syracuse, NY (#25312)... ...We partner with hospitals, clinics, nursing homes, multi-specialty... ...(ADHCP) to determine compliance with the requirements of participation... ...of clinical experience in a medical facility, preferably a...Hourly payPermanent employmentFull timeTemporary workPrivate practiceWork at officeImmediate start- ...Take the next step in your career as our new Assistant Investigator Associate to adapt to shifting priorities and business needs, coordinate tasks to ensure deadlines are met, and maintain accurate records and documentation. Other duties include support the preparation...Weekly payFlexible hoursShift work
- A federal crime enforcement agency is seeking Criminal Investigators to conduct complex investigations targeting narcotics and drug-related activities. Candidates should be U.S. citizens and able to achieve a Top-Secret security clearance. Responsibilities include preparing...
- ...Asset Protection Coordinator in Syracuse, NY. In this role, you will execute safety and shortage reduction strategies across stores, investigate theft and fraud, and train teams on safety protocols. Strong analytical and investigative skills are essential, along with the...
- ...a public notice for Drug Enforcement Administration Criminal Investigator GL-1811-7/9/11 positions open to U.S. Citizens. A job announcement... ...to any DEA location. Completion of a pre‑employment medical clearance and annual medical examination required. A full‑scope...Permanent employmentLocal areaRelocationTrial periodWeekend work
- ...drug trafficking in Syracuse, NY. Candidates must have U.S. citizenship and a valid driver's license. The role involves investigations, compliance with drug laws, and maintaining relationships with various agencies. Successful applicants will undergo rigorous testing...
$25 - $32 per hour
...& Associates, a national leader in the investigative industry, is seeking experienced SIU/Claims... ...accurate reports Obtain written and recorded statements Perform scene... ...positions are offered the following benefits: Medical, Dental, 401K, Paid Vacation and Paid Holidays...Full timePart time$25 - $30 per hour
...& Associates, a national leader in the investigative industry, is seeking experienced SIU/Claims... ...accurate reports Obtain written and recorded statements Perform scene... ...positions are offered the following benefits: Medical, Dental, 401K, Paid Vacation and Paid Holidays...Hourly payFull timePart time$39 per hour
...Master Social Worker for a role as a Nursing Home Surveyor/Complaint Investigator in Syracuse, NY. The position involves conducting investigations related to nursing home performance and ensuring compliance with quality care standards. Candidates must have a Master's...Hourly pay- ...(NINDS) Surgical Neurology Branch (SNB) Investigator (High Scarcity) - Tumor Neurosurgery The... ...SNB conducts basic, translational, and clinical research, provides neurosurgical care for... ...clinical work through outside academic medical centers will be available. Salary will be...Permanent employmentFull timeWork at office
- ...applicant.) Job Overview The Incident Investigator is responsible for conducting thorough... ...across the project. This role ensures compliance with Bechtel standards, regulatory requirements... ...package that includes comprehensive medical, dental, and vision plans, along with...16 hoursFull timeWork at officeLocal areaRemote workRelocationShift work
- Bechtel Global Corporation is hiring an Incident Investigator in Clay, NY. This role involves conducting thorough investigations of safety, health, and environmental incidents, ensuring compliance with Bechtel's standards and regulations. The ideal candidate will lead investigations...
$31 per hour
...identify opportunities Preferred Experience Associate’s degree in criminal justice or related field Certified Emergency Medical Technician (EMT) AED, APR and FAC certified At Wegmans, we’ve always believed we can achieve our goals only if we first...Full timePart timeImmediate startDay shiftAfternoon shift$25 - $32 per hour
SIU Investigator As a member of our Special Investigations Unit, you will conduct in-depth investigations into suspicious insurance claims... ...claimants and witnesses, obtain and analyze written and recorded statements, identify inconsistencies and detect fraud patterns...Hourly payImmediate startFlexible hoursShift work
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