Healthcare Fraud Investigator
Highmark Health
Highmark Inc. is seeking a seasoned fraud investigator to develop and maintain the organization’s anti-fraud program. You will conduct investigations into potential fraud, waste, and abuse across providers, members, and facilities, and coordinate with law enforcement as needed. Responsibilities include delivering fraud training, filing annual fraud plans, and supporting external regulatory bodies while testifying in court when required. Strong analytic and communication skills are essential. #J-18808-Ljbffr Highmark Health
$65k - $88.6k
...Become a part of our caring community The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The... ...Qualifications • Bachelor's degree • 2 years of healthcare fraud investigations and auditing experience • Knowledge...SuggestedFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday- ...Counselor, Office of Audits and Evaluations, Office of Healthcare Inspections, Office of Investigations, and Office of Management and Administration. In... ...procurement, benefits, education, construction, and other fraud; cybercrime and identity theft; bribery, embezzlement...SuggestedFull timeTemporary workPart timeFor contractorsWork experience placementWork at officeLocal areaImmediate startTrial period
- ...leveraging internal and external data sources to detect and mitigate fraud loss for stakeholders. Essential Job Functions Performs... ...while providing detailed documentation. Analyzes and investigates unusual activity and transactional patterns through account surveillance...SuggestedWork experience placementWork at officeLocal area
- ...leveraging internal and external data sources to detect and mitigate fraud loss for stakeholders.Essential Job FunctionsPerforms... ...stakeholders while providing detailed documentation.Analyzes and investigates unusual activity and transactional patterns through account...SuggestedWork experience placementWork at officeLocal area
- ...Criminal Investigator (Special Agent) OIG's Office of Investigations (OI) investigates potential crimes and civil violations of law involving... ..., procurement, benefits, education, construction, and other fraud; cybercrime and identity theft; bribery, embezzlement, and...SuggestedFor contractorsWork at officeLocal areaRemote work
- Criminal InvestigationA description of the business units can be found at: are to be filled in the following area(s): CI - Criminal InvestigationConsider each location carefully when applying. If you are selected for a location, that location will become your official...
- Current University of Arkansas System employees, including student employees and graduate assistants, need to log in to Workday via MyApps.Microsoft.com, then access Find Jobs from the Workday search bar to view and apply for open positions. Students at University of Arkansas...Work at officeVisa sponsorshipShift work
- ...: Employees in this position are also eligible to participate in the Company's comprehensive benefits programs, which include healthcare, life and disability insurance plans, a 401(k)-retirement savings plan, and time-off programs. Specific details of these benefits...Permanent employmentFlexible hours
- Educational Examiner Qualifications: Valid Arkansas Teaching Certificate in Educational Examiner Certification Master's Degree in Education Experience required Reports To: Director of Special Education Job Goal: Complete child-find requirements to ensure...Contract workWork at office
- ...Description Becker & Company is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is perfect... ...insurance claims including workers' compensation, suspected fraud, liability and aimed at mitigating expenses for our clients...Flexible hours
- ...J T Becker & Co Inc, based in the United States, is hiring skilled Field Investigators for flexible assignments. The selected candidates will conduct various investigations, including surveillance and SIU claims, delivering high-quality results and adhering to case manager...Flexible hours
- ...Socket.dev is seeking a 1099-Contract Investigator Technician to conduct record checks for federal background investigations on a contract basis. You will perform fieldwork to retrieve records and produce ROIs in compliance with federal laws and standards, with opportunities...Contract work
- ...pushing vehicles. Checks doors and windows and examines premises of occupied and unoccupied buildings and residences to detect and investigate suspicious conditions; identifies crime and disorder related problems; analyzes problems and develops responses to eliminate or...Local areaShift work
- ..., those who join the Secret Service are courageous, intelligent, strong and determined. A diverse team capable of balancing our investigative mission and fulfilling our protective legacy. Proven to be worthy of trust and confidence. Be tomorrow's Secret Service. Duties...Relocation
- Lead Mechanic/Chief Inspector Join our client's team as a Lead Mechanic/Chief Inspector and play a crucial role in the aviation repair station. As a top-tier engine builder, with a specialty in high-performance engines, our client is seeking a skilled and experienced...
$74.24k
Job Objective To patrol an assigned district in the City of Little Rock in order to enforce laws and ordinances. Safety Sensitive This position is designated as a safety/security sensitive position and is subject to random drug and alcohol screening. For a complete list...Immediate startShift work$27.85 - $42.44 per hour
...a disability and require reasonable accommodation, please submit your request via email to APPLICATION AND BACKGROUND INVESTIGATION: Applicants are required to complete an application and all supplemental questions on-line at Candidates will receive a confirmation...Hourly payFull timeLocal areaImmediate startShift work$74.24k
...require reasonable accommodation, please submit your request via email to ****@*****.***. APPLICATION AND BACKGROUND INVESTIGATION: Applicants are required to complete an application and all supplemental questions on-line at Candidates will receive a...Immediate startShift work- ...littlerock.gov. Any such requests must be submitted BEFORE the date of the written examination. APPLICATION AND PRELIMINARY BACKGROUND INVESTIGATION: Applicants are required to complete an application and all supplemental questions on-line at Candidates will receive a...Local areaRemote work
$27.85 - $40.8 per hour
...gov. Any such requests must be submitted BEFORE the date of the written examination. APPLICATION AND PRELIMINARY BACKGROUND INVESTIGATION: Applicants are required to complete an application and all supplemental questions on-line at Candidates will receive a...Hourly payFull timeLocal areaImmediate startRemote workShift work$46.22k
...within the assigned jurisdiction. This role involves patrolling designated areas, responding to emergency situations, conducting investigations, and engaging with the community to promote trust and cooperation. Primary Responsibilities Patrol assigned areas to deter...Work at officeLocal area$30 - $35 per hour
...opportunities for experienced, self-determined, and highly motivated Part-Time SIU INVESTIGATORS that would like to join our team of professionals in our efforts to deter and combat insurance fraud. We have several work from home, part-time and full-time hourly positions...Bi-weekly payHourly payFull timePart timeWork at officeWork from home- J T Becker & Co Inc is seeking skilled Field Investigators to join our team in Arkansas on an 'as needed' basis. This role is tailored for licensed investigators seeking flexible hours while delivering expert investigative services across various insurance claims. The ideal...Flexible hours
$56.2k - $101k
...perspective on workplace flexibility. Please note: candidates must reside in Arkansas. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that...Full timePart timeWork at officeRemote workFlexible hours$150k - $240k
...other infrastructure projects that require compliance with the NHPA and the National Environmental Policy Act. As the Principal Investigator you will plan, oversee, and support cultural resources investigations and overall responsibility for archaeological...Full timeWork at officeLocal areaRemote workFlexible hours- ...Centene Corporation is seeking a senior compliance investigations professional to lead and manage enterprise-wide investigations across Health Plans, Business Units, and Corporate functions. The role requires strong collaboration with Legal, People Relations, SIU, Privacy...
$62.7k
...for developing and maintaining an anti-fraud program which includes development and... ...incumbent is responsible for conducting investigations of organizational or functional activities... ...the health insurance industry and/or healthcare fraud investigations Preferred 1...Contract workFor contractorsWork at officeLocal area- ...ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for...Local areaNight shiftWeekend work
$25 - $32 per hour
...Description Ready to put your surveillance skills to work for a national leader?Join Lemieux & Associates, a trusted leader in investigative services, and make an impact with your surveillance expertise. Our leadership team brings over 25 years of field experience and...Part timeFlexible hours- JCPenney in Little Rock, AR seeks an Asset Protection Shrink Specialist to detect theft, conduct investigations, and support safety across stores. You will observe activities, collect evidence, interview customers or contractors, document cases, and report to AP leadership...For contractors
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