Email Alert for
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.
ION Oncology Practice Network
Conshohocken, PA, United States
Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and ani
Job Source: ION Oncology Practice NetworkCencora
Conshohocken, PA, United States
Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and ani
Job Source: CencoraTD
Cherry Hill Township, NJ, United States
Financial Analyst III 424473BR Job Category - Primary Finance / Accounting Work Location 1701 Route 70 East Employment Type Regular City Cherry Hill Time Type Full Time State New Jersey Hours 40 Pay Range $66,560 - $109,720 annually Job Details The Financial Analyst III
Job Source: TDGlaxoSmithKline, plc
Media, PA, United States
As an Investigator, within Emerging Drug Delivery Platforms you will be responsible for identifying, evaluating, and supporting the implementation of the drug delivery capabilities needed by GSK to support a rapidly growing and diversifying patient c Investigator, Product Development, Delivery, Business Services, Design, Science
Job Source: GlaxoSmithKline, plcPhiladelphia Corporation for Aging
Philadelphia, PA, United States
Title of position: Investigator I Location: Hybrid (after training) Description of Role: The Protective Services Investigator evaluates the medical, social, and psychological needs of older adults, investigates allegations of elder abuse, neglect, abandonment, and financial exploitation, and offers services to detect, reduce, correct, or elimina
Job Source: Philadelphia Corporation for AgingDefender Services Office Training Division
Philadelphia, PA, United States
FEDERAL COMMUNITY DEFENDER OFFICEFOR THE EASTERN DISTRICT OF PENNSYLVANIA DEFENDER ASSOCIATION OF PHILADELPHIA FEDERAL COURT DIVISION LISA EVANS LEWIS The Curtis - Suite 545 West JENNIFER CHICCARINO Philadelphia, PA 19106Phone: 215.928.0520 Fax: 215.928.0826 March 5, 2024 JOB ANNOUNCEMENT INVESTIGATOR/MITIGATION SPECIALISTOpen Date: March 5, 2024Cl
Job Source: Defender Services Office Training DivisionEmergencyMD
Philadelphia, PA, United States
Ethos Risk Services is continuing to expand our team of Private Field Surveillance Investigators ! We are looking for Experienced Licensed Investigators in NY, NJ, and Pennsylvania to investigate fraud and conduct covert surveillance in the field (from your vehicle). Ethos Risk is one of the largest and most respected fraud investigations
Job Source: EmergencyMDPhiladelphia Corporation For Aging
Philadelphia, PA, United States
Job Type Full-time Description Company name: Philadelphia Corporation for Aging Title of position: Investigator I Position type: Full Time Pay range: $50,400.00 - $58,344.30 varies with experience. Location: Hybrid (after training) THE ORGANIZATION A private nonprofit organization founded in 1973, Philadelphia Corporation for Aging (P
Job Source: Philadelphia Corporation For AgingPhiladelphia, PA, United States
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
JOB DESCRIPTION for Financial Investigator III
Responsible for the detection, analysis and in-depth investigation of allegations of fraud, waste and abuse against the Independence Health Group. Conducts research, data analysis and interviews to develop information necessary for the referral of suspicious activities to licensing boards and/or law enforcement agencies. Prepares and maintains files and memorandums to document the progression of assigned cases. Analyzes data and gathers information from surveillances, leads and other investigative techniques to further cases to conclusions.
MAJOR ACCOUNTABILITIES:
1. Performs in-depth investigative activities relating to alleged fraudulent claims. When requested by management and/or subpoenaed by law enforcement gathers documentation to support investigative efforts.
2. Compiles and investigates information gathered from various internal and external sources to determine financial exposure to fraud activities.
3. Builds and maintains case files for presentation to management and presents recommendations for further action.
4. Searches claims and provider systems to identify claims trends and tracks activities that may be potential fraud issues. Prepares trend reports to management.
5. Provides assistance to senior investigative staff and management on complex cases and collaborates counsel on special projects.
6. May testify on behalf of Independence as required.
7. Conducts interviews of subjects and third parties.
8. Performs other duties as assigned.
EXPERIENCE:
1. Undergraduate degree in criminal justice or related field preferred.
2. Minimum of 5 years' experience with financial, criminal or law enforcement investigations.
3. In lieu of degree, must have 8-10 years' experience in specialized law enforcement.
4. Must understand technical and financial aspects of the health insurance industry.
5. Strong writing, communication and computer skills required.
6. Experience with claims and provider systems a plus.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday) . This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania
#J-18808-Ljbffr
Email Alert for Financial Investigator II or III jobs in Philadelphia, PA, United States
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.