Investigator I

1 month ago


Durham, North Carolina, United States Elevance Health Full time
Job Summary

We are seeking a skilled Investigator I to join our team at Elevance Health. As a key member of our healthcare insurance department, you will be responsible for investigating assigned cases, collecting and analyzing claim data to detect fraudulent, abusive, or wasteful activities.

Key Responsibilities
  • Investigate assigned cases to detect and prevent healthcare insurance fraud, abuse, and waste.
  • Collect and analyze claim data to identify trends and patterns.
  • Prepare statistical and financial analyses to document findings and maintain up-to-date electronic case files.
  • Communicate findings to management and stakeholders.
Requirements
  • Bachelor's degree in a related field.
  • Minimum of 2 years of experience in healthcare insurance, law enforcement, or a related field.
  • Fraud certification from CFE, AHFI, AAPC, or coding certificates preferred.
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.



  • Durham, North Carolina, United States Elevance Health Full time

    Job Summary:The Healthcare Investigator I role at Elevance Health involves investigating assigned cases to detect fraudulent, abusive, or wasteful activities/practices in healthcare insurance payments to providers and subscribers.Key Responsibilities:Utilize system tools and databases to analyze data and review professional and facility claims.Prepare...


  • Durham, North Carolina, United States Institute for Medical Research Full time

    Job Title: Clinical Research Coordinator IWe are seeking a highly organized and detail-oriented Clinical Research Coordinator I to join our team at the Institute for Medical Research. As a Clinical Research Coordinator I, you will be responsible for overseeing select clinical research studies conducted by the Principal Investigator and his associates in...


  • Durham, North Carolina, United States KBI BioPharma Full time

    Job Summary:This Senior Manager Quality Assurance position is responsible for providing QA oversight of the Deviations, CAPA, and Complaints organization. The role will work closely with the Program Management team to facilitate communications between KBI and clients regarding quality-related events. Additionally, the Senior Manager will develop and maintain...


  • Durham, North Carolina, United States SHATTUCK LABS, INC. Full time

    Job DescriptionAbout the Position:The Associate Director/Director of Clinical Research will lead the design, conduct, analysis, and reporting of clinical trials. This individual will collaborate with the Medical Monitor to ensure clinical, scientific, and regulatory issues are addressed throughout the clinical trial. The successful candidate will act as the...


  • Durham, North Carolina, United States United Therapeutics Full time

    OverviewWe are seeking a highly skilled Clinical Product Development Expert to join our team at United Therapeutics. In this role, you will be responsible for coordinating and managing Phase I through Phase IV clinical studies, as well as supporting the conduct of preclinical studies.About the JobThe ideal candidate will have a bachelor's degree with at...


  • Durham, North Carolina, United States IQVIA Full time

    Job OverviewAs a Clinical Research Associate at IQVIA, you will play a critical role in ensuring the successful execution of clinical trials. Your primary responsibility will be to conduct site management and monitoring visits to ensure that sites are conducting the study(ies) and reporting study data as required by the study protocol, applicable regulations...


  • Durham, North Carolina, United States SpringWorks Therapeutics Full time

    About the RoleThe Director, Clinical Pharmacology will be responsible for supporting both clinical and nonclinical pharmacology activities at SpringWorks Therapeutics. This role includes working on clinical development teams to develop and implement the clinical pharmacology strategy, design clinical pharmacology studies, develop study protocols, and write...


  • Durham, United States Wake Research Full time

    Company DescriptionM3 Wake Research, an M3USA Company, is an integrated network of premier investigational sites meeting the clinical research needs of global biopharmaceutical, biotechnology, medical device, pharmaceutical and clinical research organizations (CROs). With close to 30 owned and managed research sites across the country, M3 Wake Research is...

  • Biochemist

    2 weeks ago


    Durham, United States bioMerieux Inc. Full time

    QC Biochemistry Analyst 3 - Day Shift Location: Durham, NC, United States Position Type: Unfixed Term ...

  • Biochemist

    1 week ago


    Durham, United States bioMerieux Inc. Full time

    QC Biochemistry Analyst 3 - Day Shift Location: Durham, NC, United States Position Type: Unfixed Term ...


  • Durham, United States KBI Biopharma Full time

    Position Summary:  The manufacturing execution system engineer on the technical support and investigations team will support the startup and ongoing manufacturing operations at a new biopharmaceutical manufacturing facility. During startup the individual will be responsible for supporting the introduction and qualification of the MES system at the...


  • durham, United States IntelyCare Full time

    Earn an hourly wage of up to $68 as a Registered Nurse (RN) in Durham and nearby areas, with the flexibility to live your life as you see fit. We also provide the security of W2 employment and great benefits, including eligibility for health care coverage and our 401k plan, and opportunities for career development. The most successful nursing professionals...


  • Durham, United States bioMerieux Inc. Full time

    QC Microbiology Analyst 1 Location: Durham, NC, United States Position Type: Unfixed Term ...

  • Registered Nurse

    3 months ago


    durham, United States IntelyCare Full time

    Earn an hourly wage of up to $68 as a Registered Nurse (RN) in Durham and nearby areas, with the flexibility to live your life as you see fit. At IntelyCare, founded by nurses for nurses, we value a healthy work-life balance because we know our nurse professionals perform at their best when they're not stretched thin. We also provide the security of W2...

  • Registered Nurse

    2 months ago


    durham, United States IntelyCare Full time

    Earn an hourly wage of up to $68 as a Registered Nurse (RN) in Durham and nearby areas, with the flexibility to live your life as you see fit. At IntelyCare, founded by nurses for nurses, we value a healthy work-life balance because we know our nurse professionals perform at their best when they're not stretched thin. We also provide the security of W2...

  • Registered Nurse

    2 weeks ago


    durham, United States IntelyCare Full time

    Earn an hourly wage of up to $68 as a Registered Nurse (RN) in Durham and nearby areas, with the flexibility to live your life as you see fit. At IntelyCare, founded by nurses for nurses, we value a healthy work-life balance because we know our nurse professionals perform at their best when they're not stretched thin. We also provide the security of W2...

  • Registered Nurse

    2 months ago


    durham, United States IntelyCare Full time

    Earn as much as $82 per hour as a Registered Nurse (RN) in Durham, Connecticut, and throughout the area, with the peace of mind that W2 employment provides and the freedom of a completely flexible schedule. Nursing professionals at IntelyCare, which was founded by nurses, get to choose their own shifts at our partner facilities and take time off on any day,...

  • Registered Nurse

    2 weeks ago


    durham, United States IntelyCare Full time

    Earn as much as $82 per hour as a Registered Nurse (RN) in Durham, Connecticut, and throughout the area, with the peace of mind that W2 employment provides and the freedom of a completely flexible schedule. Nursing professionals at IntelyCare, which was founded by nurses, get to choose their own shifts at our partner facilities and take time off on any day,...

  • Registered Nurse

    3 months ago


    durham, United States IntelyCare Full time

    Earn as much as $82 per hour as a Registered Nurse (RN) in Durham, Connecticut, and throughout the area, with the peace of mind that W2 employment provides and the freedom of a completely flexible schedule. Nursing professionals at IntelyCare, which was founded by nurses, get to choose their own shifts at our partner facilities and take time off on any day,...

  • Registered Nurse

    3 months ago


    durham, United States IntelyCare Full time

    Earn as much as $82 per hour as a Registered Nurse (RN) in Durham, Connecticut, and throughout the area, with the peace of mind that W2 employment provides and the freedom of a completely flexible schedule. Nursing professionals at IntelyCare, which was founded by nurses, get to choose their own shifts at our partner facilities and take time off on any day,...

  • Registered Nurse

    6 days ago


    Durham, United States IntelyCare Full time

    Earn an hourly wage of up to $68 as a Registered Nurse (RN) in Durham and nearby areas, with the flexibility to live your life as you see fit. At IntelyCare, founded by nurses for nurses, we value a healthy work-life balance because we know our nurse professionals perform at their best when they're not stretched thin. We also provide the security of W2...

  • Medical Advisor

    6 days ago


    Durham, United States bioMerieux Inc. Full time

    Medical Advisor Location: Field, United States Position Type: Unfixed Term ...

  • Medical Advisor

    1 week ago


    Durham, United States bioMerieux Inc. Full time

    Medical Advisor Location: Field, United States Position Type: Unfixed Term ...


  • Durham, United States AISIN North Carolina Corporation Full time

    Job Summary: The Machine Quality Team Member will Perform TPM duties on all manufacturing equipment and all jigs associated with the equipment. These TMs must gain knowledge on necessary hand tools, jigs, and measurement gauging to complete all required duties within the spectrum of the MQ TM's job responsibilities. *Please be advised that skills testing...

  • Inspector, QA

    2 months ago


    Durham, United States LC Industries Full time

    I. JOB DESCRIPTIONDepartment: ManufacturingLocation:DurhamReports to:Quality Manager/QSE AdministratorII. STATEMENT OF PURPOSEPerforms quality raw material receiving, work in-process, and end item inspection at defined points of inspection.III. RESPONSIBILITY FOR WORK OF OTHERSNoneIV. BUSINESS COMMUNICATIONMust be able to communicate with manager and...


  • Durham, United States IntelyCare Full time

    Earn as much as $82 per hour as a Registered Nurse (RN) in Durham, Connecticut, and throughout the area, with the peace of mind that W2 employment provides and the freedom of a completely flexible schedule. Nursing professionals at IntelyCare, which was founded by nurses, get to choose their own shifts at our partner facilities and take time off on any day,...


  • Durham, United States Durham County, NC Full time

    Durham County Government employs approximately 1,900 employees that work towards providing needed services throughout the community. With a wide array of services, Durham County Government is at the heart of a rapidly growing and diverse area offering residents, employees and visitors exciting opportunities to live, work, grow and play. For more information...