Current jobs related to Financial Investigator Iii - Philadelphia - Independence Blue Cross
-
Financial Investigator
3 weeks ago
Philadelphia, Pennsylvania, United States Ohm Systems, Inc Full timeAbout Ohm Systems, Inc: Ohm Systems, Inc. specializes in IT and Healthcare staffing services, dedicated to linking highly skilled professionals with our public and private clients across the United States. Our track record showcases our commitment to delivering outstanding staffing and consultancy solutions to our clients. We prioritize diversity and...
-
Financial Analyst and Investigator
1 week ago
Philadelphia, Pennsylvania, United States Ohm Systems, Inc Full timeAbout the RoleWe are seeking a highly skilled Financial Analyst and Investigator to join our team at Ohm Systems, Inc. As a key member of our team, you will be responsible for conducting financial analysis and investigations in support of our clients' needs.Key ResponsibilitiesFinancial Analysis: Conduct thorough financial analysis and investigations to...
-
Financial Crimes Investigator
5 days ago
Philadelphia, Pennsylvania, United States Dexian Full timeJob Title: Financial Crimes InvestigatorJoin Dexian, a leading provider of staffing, IT, and workforce solutions, as a Financial Crimes Investigator. In this role, you will be part of an ongoing customer remediation project, working to get back to speed and drive process improvements within the Financial Crimes Department.Key Responsibilities:Participate in...
-
Financial Crime Investigator
1 week ago
Philadelphia, United States Dexian Full timeJob Title : Financial Crimes InvestigatorWork Location: Philadelphia, PA 19103Duration: 6+ Month Contract (Possible Extension)Start Date:10/07/2024.Payrate $43 – $44.68/hr.Job Title : Financial Crimes InvestigatorWork Location: Philadelphia, PA 19103Duration: 6+ Month Contract (Possible Extension)Start Date:10/07/2024.Payrate $33 – $58/hr.Payrate is...
-
Financial Crimes Investigator
1 week ago
Philadelphia, United States Collabera Full timeDescription Home Search Jobs Job Description Financial Crimes Investigator Contract: philadelphia, Pennsylvania, US Salary: $50.00 Per Hour Job Code: 353903 End Date: 2024-10-17 Days Left: 29 days, 3 hours left Apply Position: Financial Crimes specialist Industry: Banking Job duration: 06 months (with Possibilities of Extension OR FTE) Location:...
-
Financial Operations Specialist
7 days ago
Philadelphia, Pennsylvania, United States Axcelus Financial Full timeAccounting Associate RoleAt Axcelus Financial, we are seeking a highly skilled and detail-oriented Accounting Associate to join our team. This role will be responsible for supporting various general accounting, treasury, and financial reporting duties associated with Axcelus Financial and its affiliate entities.Key Responsibilities:Monitor and maintain daily...
-
Investigational Pharmacy Technician
3 weeks ago
Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full timeJob SummaryPenn Medicine is committed to delivering exceptional patient care, advancing medical research, and educating future healthcare professionals. As a Pharmacy Technician III - Clinical Trials Support, you will play a vital role in our Investigational Drug Services team.Key ResponsibilitiesProvide patient care services to individuals enrolled in...
-
Investigator
3 weeks ago
Philadelphia, United States Disability Solutions Full timeDescription:ABOUT US: Frasco Investigative Services, a division of Frasco, Inc., provides unparalleled quality investigations throughout the entire United States. Frasco is a full-service investigation corporation serving the insurance, legal, employment, and entertainment communities. Our client base includes many of the nation's largest insurance carriers...
-
Financial Crimes Investigator
1 week ago
philadelphia, United States Collabera Full timePosition: Financial Crimes specialist Industry: Banking Job duration: 06 months (with Possibilities of Extension OR FTE) Location: Philadelphia, PA PROJECT SUMMERY: In this assignment, you will: This assignment is specific to contingent resources Consult on complex initiatives with broad impact and large-scale planning for Financial Crimes ...
-
Financial Crimes Investigator
1 week ago
Philadelphia, United States Collabera Full timePosition: Financial Crimes specialist Industry: Banking Job duration: 06 months (with Possibilities of Extension OR FTE) Location: Philadelphia, PA PROJECT SUMMERY: In this assignment, you will: This assignment is specific to contingent resources Consult on complex initiatives with broad impact and large-scale planning for Financial Crimes ...
-
Financial Crimes Investigator
1 week ago
Philadelphia, United States Collabera Full timePosition: Financial Crimes specialistIndustry: BankingJob duration: 06 months (with Possibilities of Extension OR FTE)Location: Philadelphia, PA PROJECT SUMMERY:In this assignment, you will:This assignment is specific to contingent resourcesConsult on complex initiatives with broad impact and large-scale planning for Financial CrimesReview and analyze...
-
Account Executive III
4 days ago
Philadelphia, Pennsylvania, United States Vericast Full timeJob DescriptionVericast is seeking a highly skilled Account Executive III - Financial Services to join our team. As a key member of our sales team, you will be responsible for achieving sales and/or profitability goals, from both existing accounts and new client prospects.Key Responsibilities:Participate in a high level of prospecting activities: lead...
-
Fraud Investigator
1 week ago
Philadelphia, United States Collabera Full timeJob Details: Title: Fraud InvestigatorLocation: Philadelphia, PADuration: 06 months of contract | Onsite Pay: $33/Hr. to $75/Hr. (Based upon experience)Job Description: Consult on complex initiatives with broad impact and large-scale planning for Financial CrimesReview and analyze complex multi-faceted, larger scale or longer-term Financial Crimes...
-
Background Investigator
1 week ago
Philadelphia, Pennsylvania, United States Peraton Full time{"Job SummaryPeraton is seeking a skilled Background Investigator to join our team in Philadelphia, PA. As a Background Investigator, you will be responsible for conducting thorough background investigations to determine employment suitability of individuals requiring access to sensitive or classified U.S. Government information.Responsibilities* Conduct...
-
Fraud Investigation Analyst
4 weeks ago
Philadelphia, Pennsylvania, United States Chubb Full timeJob OverviewPosition Title: Fraud Investigation Analyst Field of Interest: Insurance - Claims Management Location: USAStates: Pennsylvania and New Jersey Key Cities: Philadelphia, PA; White House Station, NJ; Jersey City, NJ Role SummaryAre you prepared to become part of an innovative team within the insurance sector dedicated to uncovering fraudulent...
-
Case Manager III
1 month ago
Philadelphia, United States Acadia Healthcare Full timeDescription Belmont Behavioral Hospital is a premiere provider of comprehensive treatment for mental health conditions and substance abuse problems. Having been in operation for over 75 years as one of the most prominent providers of behavioral healthcare treatment services, Belmont is proud to offer high quality and specialized programming options for...
-
Disputes and Investigations Manager
12 hours ago
Philadelphia, Pennsylvania, United States Alvarez & Marsal Europe Full timeJob Title: Disputes and Investigations ManagerJoin Alvarez & Marsal Europe as a Disputes and Investigations Manager and take your career to the next level. As a key member of our team, you will be responsible for resolving complex matters that pose a threat or disruption to normal operations for our clients.Key Responsibilities:Work closely with senior team...
-
Background Investigator
2 weeks ago
Philadelphia, Pennsylvania, United States Peraton Full timeJob SummaryWe are seeking a highly skilled Background Investigator to join our team at Peraton. As a Background Investigator, you will be responsible for conducting thorough background investigations to determine employment suitability of individuals requiring access to sensitive or classified U.S. Government information.Key ResponsibilitiesConduct in-person...
-
Background Investigator
2 weeks ago
Philadelphia, Pennsylvania, United States Peraton Full timeJob SummaryWe are seeking a highly skilled Background Investigator to join our team at Peraton. As a Background Investigator, you will be responsible for conducting thorough background investigations to determine employment suitability of individuals requiring access to sensitive or classified U.S. Government information.Key ResponsibilitiesConduct in-person...
-
Pharmacy Technician III
3 weeks ago
Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full timeJob SummaryPenn Medicine is committed to delivering exceptional patient care, advancing medical research, and educating future healthcare professionals. As a Pharmacy Technician III - Clinical Trials Support, you will play a vital role in our Investigational Drug Services (IDS) team.Key ResponsibilitiesProvide patient care services to individuals enrolled in...
Financial Investigator Iii
3 months ago
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.
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_
