- Usaa (Knoxville, TN)
- …from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and regulations and ... us special and impactful. The Opportunity We are looking for a SIU Investigator (mid-level). This is a desk position. Within defined guidelines and framework,… more
- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This team ... Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator , you will serve...and will oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program… more
- Humana (Santa Fe, NM)
- …of situations or data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law enforcement ... health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit....of all do you have a passion for combating Fraud , Waste, and Abuse in the Health Care Industry?… more
- Elevance Health (Seattle, WA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Zions Bancorporation (Midvale, UT)
- …endless. You bring the talent; we bring the opportunity. We are currently seeking a ** Fraud Investigator ** to join our team. This position will be in office, ... (ACFCS) is a plus. . Basic working knowledge of fraud detection/prevention principals, BSA/AML Compliance as it...working knowledge of fraud detection/prevention principals, BSA/AML Compliance as it applies to suspicious activity for money… more
- ADP (San Dimas, CA)
- …and resolve issues + Identify process gaps and propose solutions to enhance fraud detection and mitigation + Support compliance initiatives, audits, and ... 2 days at home).** + 5+ years of experience in fraud investigation, risk management, or compliance + Strong Excel skills and technical proficiency in data… more
- Point32Health (Canton, MA)
- …currently seeking highly motivated individuals to join our organization as a Fraud Operations Specialist within our Special Investigations Unit ("SIU"). The Fraud ... parties with direct interaction with the SIU. The Sr. Fraud Operations specialist will also create and deliver anti-...preparation and response. + Maintain SIU contractual and regulatory compliance including serving as the point person for SIU… more
- Humana (Lincoln, NE)
- …part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud ...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- SCI Shared Resources, LLC (Houston, TX)
- …associates celebrate lives. We celebrate our associates. Conducts criminal and fraud investigations while enforcing criminal laws and institutional regulations that ... quickly to new work structures, processes, requirements or cultures. Ensures compliance with local, state, and federal regulations. + Recommends efficiencies to… more
- Capital One (Richmond, VA)
- …Diploma, GED or equivalent certification + At least 1 year of leadership experience in Fraud , AML investigations or a Compliance role + At least 2 years of ... AML Senior Investigator II-SIU Supervisor **The Anti-Money Laundering (AML) Supervisor**...+ 2 + years of people leader experience in Fraud , AML investigations, or Compliance role +… more
- City of New York (New York, NY)
- Job Description IMPORTANT NOTE: ONLY CANDIDATES WHO HAVE A PERMANENT ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR WHO ARE REACHABLE ON THE CURRENT ... ASSOCIATE FRAUD INVESTIGATOR EXAM NO. 4013 WILL BE...efficiently, and transparently to instill public confidence and encourage compliance while providing exceptional customer service. DOF's Sheriff's Office… more
- Allied Universal (Crossville, TN)
- …+ One or more of the following professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... or adjusting complex insurance claims + Proficient understanding and application of anti- fraud laws, insurance regulations, and compliance standards within their… more
- Allied Universal (Cape Coral, FL)
- …+ One or more of the following professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... investigations or adjusting complex claims + Working knowledge and understanding of anti- fraud laws, insurance regulations, and compliance rules and standards in… more
- MyFlorida (Pensacola, FL)
- LAW ENFORCEMENT INVESTIGATOR II - 41001250 1 Date: Dec 10, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Office of the Attorney General Working Title: LAW ENFORCEMENT INVESTIGATOR II - 41001250 1 Pay Plan: Career Service...the Office of the Attorney General within the Medicaid Fraud Control Unit in Pensacola, Florida. Pay:$60,000.20 - $62,425.00… more
- Capital One (Wilmington, DE)
- Anti-Money Laundering (AML) Sr. Investigator II - Enhanced Due Diligence (EDD) The Anti-Money Laundering (AML) Sr. Investigator II supervises various AML ... activities as well as managing the workflow of the AML analysis. The AML Investigator II coaches their team and teaches others about AML processes through training… more
- MyFlorida (Orlando, FL)
- …OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY CLASS TITLE: LAW ENFORCEMENT INVESTIGATOR II (SWORN INSURANCE FRAUD DETECTIVE) DIVISION: ... LAW ENFORCEMENT INVESTIGATOR II - 43005064 Date: Dec 22, 2025...Services. This advertisement is for a Bureau of Insurance Fraud detective. Click here (https://www.myfloridacfo.com/division/cid/home) for additional information about… more
- AIG (Atlanta, GA)
- …the way we help customers to manage risk. Join us as a Principal Claims Investigator to play your part in that transformation. It's an opportunity to grow your ... How you will create an impact The Principal Claims Investigator is responsible for all aspects of the investigation...will leverage knowledge and expertise to ensure that the fraud risk to AIG is minimized. As an Insurance… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …this position is responsible for the accurate and thorough clinical investigation of potential fraud , waste and abuse (FWA) for all lines of business. The scope of ... investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Market Regulation Investigator - Insurance Complaint Analyst Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/5138436) Apply Market Regulation ... Investigator - Insurance Complaint Analyst Salary $62,337.60 - $96,699.20...vital role in identifying and mitigating risks associated with fraud and misconduct in the Insurance Industry regulatory environment.… more
- USAA (San Antonio, TX)
- …from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and regulations and ... us special and impactful. **The Opportunity** We are looking for a SIU Investigator (mid-level). **This is a "Desk" position.** **Besides solid experience as an SIU… more
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