- Wells Fargo (Chandler, AZ)
- **About this role:** Wells Fargo is seeking a Fraud & Claims Operations Senior Manager in Consumer & Small Business Banking providing coverage for the ... ensure proactive identification, prevention, detection, investigation and/or reporting of fraud and claims activity + Engage and...allocation of people and financial resources for Frauds and Claims Operations + Develop and guide a… more
- Fallon Health (Worcester, MA)
- …Provide training to SIU staff related to clinical topics as neededFWA Manager will oversees the day-to-day operations over investigations and allegations ... leadership of the Fraud , Waste and Abuse (FWA) program. The FWA Manager will be responsiblefor general supervisionover a number of staff engaged in FWA auditing… more
- Under Armour, Inc. (Baltimore, MD)
- …UA Protect, Investigations and DH teams on cross-functional investigations + Represent Fraud Operations with integrity and professionalism + Assist with ... + Protect the business from non-traditional card not present fraud including but not limited to claims ...tasks such as special projects, other duties assigned by Manager **What do you need?** + **GET IT DONE… more
- Regions Bank (Hoover, AL)
- …**Job Description:** At Regions, the Financial Crimes Fraud Specialist monitors fraud prevention reports and/or reviews and resolves claims to address ... or other bank products + Identifies valid and fraudulent charges, sets up fraud files, uses multiple research techniques to resolve issues, reconciles and summarizes… more
- USAA (Barnstable, MA)
- …part of what truly makes us special and impactful. **The Opportunity** As a dedicated Manager , Claims Operations you will lead and be accountable for auto, ... property, and other claims operations member service employees who are...+ Familiarity with salvage procedures, identifying possible subrogation files, fraud identification, as well as claims systems… more
- HomeSafe Alliance (Columbus, OH)
- **Title:** Claims Manager (HHG/Military Move) **_HomeSafe Alliance_** is the single global household goods movement manager of over 300,000 Military ... Role** **HomeSafe Alliance** is seeking highly skilled and motivated ** Claims Manager ** to assist in all aspects...in this role. **Position Description/Job Responsibilities** + Manage the operations of the claims department to meet… more
- OneMain Financial (Baltimore, MD)
- … Fraud Challenge o Ability to discuss feasibility and appropriateness of high dollar Fraud claims with Customers o Ability to differentiate Fraud types ... ** Claims Analyst/ Investigator** . Excited to grow your.... Judgmental skills necessary to escalate high-risk matters to Fraud Manager , Senior Investigator and/or management. .… more
- AIG (Lenexa, KS)
- …we are reimagining the way we help customers to manage risk. Join us as a Claims Examiner IV, Accident & Health to play your part in that transformation. It's an ... the team. Make your mark in Accident and Health Claims Our Claims teams are the proven...where warranted. + Recognize and make appropriate Risk and Fraud referrals. + Handle high technical and severity losses… more
- Catholic Health Services (Melville, NY)
- …Job Details Under minimal supervision, formulates and defines Resolute Hospital Billing/ Claims scope and objectives through research and fact-finding to develop or ... will be implemented. Builds, tests, documents and maintains the EPIC Resolute Hospital Billing/ Claims program. Is competent to work on all phases of Epic Resolute… more
- RELX INC (Duluth, GA)
- …about LexisNexis Risk at the link below. https://risk.lexisnexis.com/insurance About the team: Claims Record Unit (CRU) is a division of LexisNexis Risk Solutions, ... nationwide. Insurance carriers use these records to aide in the adjudication of claims . We process 8 million requests annually and foster business relationships with… more
- Walmart (Wintersville, OH)
- …business stakeholders to solve complex business issues (for example, business operations , necessary skills,). Develops business cases for projects with projected ... practices and policies. Lists common tasks and activities performed by operations functions and subfunctions. Asset Protection & Security Possesses knowledge of:… more
- Walmart (Lebanon, PA)
- …business stakeholders to solve complex business issues (for example, business operations , necessary skills,). Develops business cases for projects with projected ... practices and policies. Lists common tasks and activities performed by operations functions and subfunctions. Asset Protection & Security Possesses knowledge of:… more
- Lincoln Financial Group (Columbus, OH)
- …#:** 74141 **The Role at a Glance** We are excited to bring on an ** Operations Manager ** to join the Retirement Plan Services organization in a work from ... home environment. _Background Details_ As the Retirement Operations Manager , you will manage the Participant Service teams, encompassing the Money In,… more
- AIG (Atlanta, GA)
- …insurance experience and to develop the staff into AIG's next generation of claims adjusters, underwriters, operations specialist, etc. + Provide weekly or ... Make your mark in Claims Our Claims teams are the...create an impact As Claim Intake Department (C ID) Manager , you will be responsible for managing a staff… more
- State of Massachusetts (Boston, MA)
- …Stay updated on changes in legislation and best practices related to unemployment fraud . Flag suspicious employer accounts and fraudulent claims for further ... available for work and looking for a job. The Manager of Program Integrity plays a crucial role in...compliance with relevant regulations, and enhancing the effectiveness of fraud detection and prevention measures. As a direct report… more
- CareOregon (Portland, OR)
- …the Code of Federal Regulations, Oregon Revised Statutes and Administrative Rules, HIPAA, Fraud , Waste, and Abuse laws, False Claims Act, Anti-Kickback laws, ... Job Title Delegation and Quality Oversight Manager Exemption Status Exempt Department Health Share of...of that team includes delegation oversight of subcontracted entities, fraud waste and abuse prevention planning and investigations, grievances,… more
- Harvard University (Cambridge, MA)
- …timeframes (specifically Regulation E). + Monitors losses due to disputes and fraud , including bond claims . + Manages digital communications, ensuring quality ... to the Card Services Manager , the Assistant Manager is responsible for directing the operations ...quality member service, and overall member experience. The Assistant Manager handles or delegates disputes and fraud ,… more
- Kemper (Los Angeles, CA)
- …oral and written communications skills and promote a favorable company image to the public. + Fraud Claims Law Specialist (FCLS) or Fraud Claims Law ... SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit.… more
- Kemper (Miami, FL)
- …oral and written communication skills and promote a favorable company image to the public. + Fraud Claims Law Specialist (FCLS) or Fraud Claims Law ... The SIU Investigator will conduct field and desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit.… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …review nurses, operations associates and others that may assist in fraud detection and investigation. + Collect and preserve detailed evidence for successful ... + Significant experience with relevant technology, such as background check systems, claims processing platforms, data mining, and fraud detection software. +… more
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