Compliance Investigator jobs in Brockton, MA
Compliance Investigator conducts investigations of alleged violations of the corporation's ethical standards or non-compliance with applicable laws, regulations and corporate policy. Ensures that investigations follow the approved process, are lawfully and objectively conducted, are thorough in gathering all material facts and present an accurate accounting of the issues. Being a Compliance Investigator presents clear, concise, and factual reports that enable fair and relevant decisions to be made. Recommends proactive measures that will reduce the risk of similar future incidents. Additionally, Compliance Investigator typically requires a bachelor's degree. Typically reports to a manager or head of a unit/department. May require a Certified Fraud Examiner (CFE) certification. The Compliance Investigator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Compliance Investigator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
Recently Added Compliance Investigator jobs
SIU Investigator
- Point32Health
-
Canton, MA
FULL_TIME
-
Who We ArePoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, clickhere.Job SummaryPoint32Health is currently seeking highly motivated individuals to join our organization as a nInvestigator within our Special Investigations Unit (“SIU”). The Investigator is an essential team member of the SIU, responsible for leading complex provider investigations related to fraud, waste and abuse, and developing action plans to address the investigative findings and prevent future loss. The Investigator works closely with other members of the SIU to set investigative priorities, develop effective investigative strategies and techniques, and recommend measures to address new and evolving schemes.Key Responsibilities/Duties – what you will be doing
- Leading complex investigations, involving internal and external research, detailed data analyses, review of medical records, and interviews of members, providers, and other third parties.
- Applying laws, regulations, plan policies and guidelines, contract provisions, coding rules, coverage rules, and industry standards to information gathered during the investigation.
- Preparing reports of investigative findings and reporting investigative findings to providers.
- Working with SIU management to educate providers, recover overpayments, take action to prevent future loss, and monitor provider activity post-investigation
- Identifying root causes of fraud, waste and abuse and recommending internal and external corrective actions to address these root causes.
- Recommending investigative priorities, strategies, and techniques.
- Working with the analytics and intake team to develop and refine data mining to address new and evolving schemes.
- Sharing expertise and promoting investigative best practices among SIU management and staff. Educating and collaborating with various business units to raise awareness of potential FWA concerns.
- Performing out-of-the-box thinking, collaborate with others, and make a difference every day!
Other duties as assigned by the Director.Qualifications – what you need to perform the job- Bachelor’s degree, preferably in a clinical or scientific field, business, accounting, computer science, or criminal justice.
- 1-3 experience in health care or investigations
- Certified Professional Coder (“CPC”); Certified Fraud Examiner (“CFE”) designation a plus.
- Experience in audits/investigations (preferred).
- Ability to produce clear, concise, and well-organized documents.
Compensation & Total Rewards OverviewAs part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:- Medical, dental and vision coverage
- Retirement plans
- Paid time off
- Employer-paid life and disability insurance with additional buy-up coverage options
- Tuition program
- Well-being benefits
- Full suite of benefits to support career development, individual & family health, and financial health
For more details on our total rewards programs, visithttps://www.point32health.org/careers/benefits/Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health EquityPoint32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. - 17 Days Ago
Surveillance Investigator
- Allied Universal
-
Foxboro, MA
FULL_TIME
- Allied Universal® Compliance and Investigations, North America’s leading expert insurance claim investigations, compliance and corporate governance company, provides rewarding careers that give you a ...
- 13 Days Ago
Surveillance Investigator
- Allied Universal®
-
Foxborough, MA
FULL_TIME
- Surveillance Investigator Overview Allied Universal® Compliance and Investigations, North America's leading expert insurance claim investigations, compliance and corporate governance company, provides...
- 14 Days Ago
SIU Investigator
- P32HS Point32Health Services Inc
-
Canton, MA
FULL_TIME
- Who We Are Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building...
- 1 Month Ago
Compliance Technician
- Dependable Service Company
-
Plymouth, MA
FULL_TIME
- Compliance Technician for growing Petroleum Company If you are a motivated individual that is looking for year-round employment with an opportunity to advance, you may be the person we are looking for...
- 11 Days Ago
Compliance Coordinator
- Dependable Service Company
-
Plymouth, MA
FULL_TIME
- We are searching for motivated, dependable candidate to manage Dependable Service Company's Compliance program. Including the management of the inspectors and compliance testers, scheduling, managing ...
- 14 Days Ago
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0 Compliance Investigator jobs found in Brockton, MA area
Financial Reporting Staff Accountant
- Rockland Trust
-
Rockland, MA
- This role is crucial in supporting the team's efforts to meet goals and deadlines while ensuring the accuracy and compli...
- 4/25/2024 12:00:00 AM
Cyber Security Manager
- PRI Technology
-
Cranston, RI
- I have a full-time role for a CyberSecurity Manager in Cranston RI for one of our top tier clients. This role will need ...
- 4/24/2024 12:00:00 AM
Quality Compliance Manager
- EMD Serono, Inc.
-
Rockland, MA
- Quality Compliance Manager 100% onsite in MA Pay: $60.00 an hour Bachelor's degree with a minimum of 3 years in a qualit...
- 4/24/2024 12:00:00 AM
Manager of Security
- PRI Technology
-
Pawtucket, RI
- Job Description Job Description I have a full-time role as a hands-on Manager of Security in Pawtucket RI for one of our...
- 4/23/2024 12:00:00 AM
Financial Reporting Specialist
- Needham Bank
-
Needham, MA
- Job Description About Us: Needham Bank is a leading public financial institution dedicated to providing exceptional bank...
- 4/23/2024 12:00:00 AM
Regional PV Manager
- Workday
-
Bridgewater, MA
- Regional PV Manager Internal posting title: Deputy Country Safety Head, US and CanadaLocation: Bridgewater, NJRemote Wor...
- 4/22/2024 12:00:00 AM
Regional PV Manager
- Sanofi
-
Bridgewater, MA
- Internal posting title: Deputy Country Safety Head, US and CanadaRemote Work: HybridJob Type: Full timeAbout the Job At ...
- 4/22/2024 12:00:00 AM
Cyber Security Manager
- Pri Technology
-
Cranston, RI
- I have a full-time role for a CyberSecurity Manager in Cranston RI for one of our top tier clients. This role will need ...
- 4/21/2024 12:00:00 AM
About Brockton, Massachusetts
According to the United States Census Bureau, the city has a total area of 21.6 square miles (56 km2), of which 21.5 square miles (56 km2) is land and 0.1 square miles (0.26 km2) (0.56%) is water. Brockton is the 162nd largest city by land area in the Commonwealth, and the twelfth largest of the twenty-seven towns in Plymouth County. Brockton is bordered by Stoughton to the northwest, Avon to the north, Holbrook to the northeast, Abington to the northeast, Whitman and East Bridgewater to the southeast, West Bridgewater to the south, and Easton to the west. Brockton is approximately 25 miles s...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Compliance Investigator jobs
$86,737 to $141,617
Brockton, Massachusetts area prices
were up 1.6% from a year ago
were up 1.6% from a year ago
What does a Compliance Investigator do?
Compliance Investigator in Sumter, SC
Compliance officers often work for specific businesses or organizations and are tasked with making sure the work being done meets legal, ethical, and even quality standards.
December 09, 2019
Compliance Investigator in Abilene, TX
Many companies look for compliance officers with at least five years of experience related to their field.
December 05, 2019
Compliance Investigator in El Paso, TX
Becoming a compliance officer means gaining an encyclopedic knowledge of the regulations relevant to a particular field, then being able to apply that data practically and analytically.
November 12, 2019