Healthcare Fraud Investigator Salary in Hawaii

Job Description Job Description A Fraud Investigator is responsible for leading and conducting simple to complex investigations related to financial fraud and other fraudulent activities within the bank. This position requires extensive experience in fraud detection, prevention, and investigation, as well as a strong understanding of banking regulations and industry best practices. The Fraud Investigator will work closely with cross-functional teams to identify, mitigate, and prevent fraudulent activities, protecting the bank and its customers from financial losses. You will proactively coordinate with BSA/Compliance, Operations and Call Center to respond to customer inquiries, evaluate and recommend improvements to processes or procedures, draft procedures and create controls, and promote a positive customer experience while minimizing loss and risk. We have 2 open positions for Fraud Investigator. Key Responsibilities: Lead and conduct comprehensive investigations into suspected case

Company : Highmark Inc. Job Description : JOB SUMMARY The incumbent is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. Must be able to testify in a court of law, prepare cases for referral to various federal, state and lo

Company : Highmark Inc. Job Description : JOB SUMMARY The incumbent is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. Must be able to testify in a court of law, prepare cases for referral to various federal, state and lo

Company : Highmark Inc. Job Description : JOB SUMMARY The incumbent is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. Must be able to testify in a court of law, prepare cases for referral to various federal, state and lo

Qualifications: •A minimum of a four-year college degree, either specifically in accounting, finance, economics, computer science with data analysis, applied statistics or equivalent post-college work experience. •Excellent analytical, communication, and organizational skills. •The ability to function as an integral part of an investigative team and work in a group setting. •Knowledge of fundamental computer applications, such as Word, Excel, and Access. •Proficiency with presentation software, such as PowerPoint. Preferred skills: •The ability to review financial records and advise or assist in the investigation of alleged fraud. •Designation as a Certified Fraud Examiner. •Experience with statistical sampling and/or advanced statistical training. •Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data. •A CPA is not required, but the position qualifies for CPA accreditation purposes. Duties Descript

About Ascendion Ascendion is a full-service digital engineering solutions company. We make and manage software platforms and products that power growth and deliver captivating experiences to consumers and employees. Our engineering, cloud, data, experience design, and talent solution capabilities accelerate transformation and impact for enterprise clients. Headquartered in New Jersey, our workforce of 6,000+ Ascenders delivers solutions from around the globe. Ascendion is built differently to engineer the next. Ascendion | Engineering to elevate life We have a culture built on opportunity, inclusion, and a spirit of partnership. Come, change the world with us: Build the coolest tech for the world’s leading brands Solve complex problems – and learn new skills Experience the power of transforming digital engineering for Fortune 500 clients Master your craft with leading training programs and hands-on experience. Experience a community of change-makers! Join a culture of high-performing i