Investigator SrHybrid
Norfolk, VA ยท Hybrid
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with ...
Norfolk, VA ยท Hybrid
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with ...
Norfolk, VA ยท Hybrid
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with ...
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
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Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
New York, NY ยท On-site +1
AHFI and/or CFE certification (Preferred) * 4 - 6+ years of relevant, professional work experience * Additional experience/specialized training may be considered in lieu of a bachelor's degree ...
New York, NY ยท On-site +1
AHFI and/or CFE certification (Preferred) * 4 - 6+ years of relevant, professional work experience * Additional experience/specialized training may be considered in lieu of a bachelor's degree ...
Alexandria, VA ยท On-site +1
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
Alexandria, VA ยท On-site +1
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML (Anti-Money Laundering) and Fraud Professional (CAFP), or similar desired. * Additional Certifications:
New York, NY ยท On-site +1
AHFI and/or CFE certification (Preferred. * 4 - 6+ years of relevant, professional work experience (Required) * Additional experience/specialized training may be considered in lieu of a bachelor ...
New York, NY ยท On-site +1
AHFI and/or CFE certification (Preferred. * 4 - 6+ years of relevant, professional work experience (Required) * Additional experience/specialized training may be considered in lieu of a bachelor ...
New York, NY ยท On-site +1
$68K - $118K/yr
AHFI and/or CFE certification (Preferred. * 4 - 6+ years of relevant, professional work experience (Required) * Additional experience/specialized training may be considered in lieu of a bachelor ...
New York, NY ยท On-site +1
$68K - $118K/yr
AHFI and/or CFE certification (Preferred. * 4 - 6+ years of relevant, professional work experience (Required) * Additional experience/specialized training may be considered in lieu of a bachelor ...
New York, NY ยท On-site +1
$68K - $118K/yr
AHFI and/or CFE certification (Preferred) * 4 - 6+ years of relevant, professional work experience * Additional experience/specialized training may be considered in lieu of a bachelor's degree ...
New York, NY ยท On-site +1
$68K - $118K/yr
AHFI and/or CFE certification (Preferred) * 4 - 6+ years of relevant, professional work experience * Additional experience/specialized training may be considered in lieu of a bachelor's degree ...
Long Beach, CA ยท On-site +1
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท On-site +1
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท On-site +1
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท On-site +1
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท On-site +1
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Long Beach, CA ยท On-site +1
$19.64 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$21.82 - $42.55/hr
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). * Experience working in group health insurance, particularly within claims processing or operations. * Working ...
$8.89 - $13.70
16% of jobs
$15.17 is the 25th percentile. Wages below this are outliers.
$13.70 - $18.51
29% of jobs
The median wage is $19.71 / hr.
$18.51 - $23.32
19% of jobs
$27.58 is the 75th percentile. Wages above this are outliers.
$23.32 - $28.13
12% of jobs
$28.13 - $32.93
8% of jobs
$32.93 - $37.74
5% of jobs
$37.74 - $42.55
4% of jobs
$42.55 - $47.36
2% of jobs
$47.36 - $52.16
2% of jobs
$52.16 - $56.97
1% of jobs
$56.97 - $61.78
1% of jobs
$8
$26
$61
| Aspect | Ahfi | HVAC Technician |
|---|---|---|
| Required Certifications | Typically none or specialized safety certifications | HVAC certification, EPA certification |
| Work Environment | Industrial, manufacturing, or safety-focused settings | Residential, commercial, or industrial HVAC systems |
| Industry Usage | Used in safety and industrial sectors | Commonly employed in building climate control |
| Job Focus | Safety, compliance, and industrial processes | Installation, maintenance, and repair of HVAC systems |
Ahfi and HVAC Technician roles differ mainly in their focus and work environment. Ahfi professionals often work in industrial or safety-related settings with minimal certifications, while HVAC Technicians focus on climate control systems, requiring specific certifications. Both roles are essential in their respective industries but serve different purposes and environments.

Contractor
Posted 26 days ago
Apply Schedule: 1-2 days per week in the office (Hybrid 1) Job no: PF6MM Category: Healthcare Application Deadline is Friday 4th of March Nike offers a generous total rewards package, casual work environment, a diverse and inclusive culture About the job Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. The Investigator Sr.
position is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. Candidate will need a strong Medicare/Medicaid background with a focus on Pharmacy. How You Will Make An Impact Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.
Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one company health plan, line of business and/or state. May interface internally with Senior level management and legal department throughout investigative process. May assist in training of internal and external entities.
Assists in the development of policy and/or procedures to prevent loss of company assets. May be called upon to represent the Company in court proceedings regarding research findings. Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting.
Develops and maintains a high degree of rapport and cooperation with the Federal, State and local law enforcement and regulatory agencies which can assist in investigative efforts. Minimum Requirements Requires a BA/BS and minimum of 5 years related experience in healthcare insurance and healthcare insurance investigation, law enforcement; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities And Experiences Pharmacy investigation experience is highly preferred.
Professional certification of CFE, AHFI, CPC, Paralegal, RN, JD or other job-related designation preferred. Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred. Published on 18 Dec 2024, 7:01 PM.