- Highmark Health (Dover, DE)
- …**Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year ... fraud , waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to...in Financial Analysis in an acute care hospital or health insurance setting + 1 year in… more
- Humana (Indianapolis, IN)
- …**Required Qualifications** + Bachelor's degree + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment ... part of our caring community and help us put health first** This Senior Fraud and Waste...encourage sensible and culturally-competent business standards + Oversee internal investigations of FWA compliance issues + Work with the… more
- US Bank (Columbus, OH)
- …are responsible for submitting Suspicious Activity Reports (SARSs) as it relates to fraud . Ensures team meets or exceeds production and quality goals. Partners with ... designed to help you and your family boost your health , protect your financial security and give you peace...dental, vision) + Basic term and optional term life insurance + Short-term and long-term disability + Pregnancy disability… more
- Fallon Health (Worcester, MA)
- …inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of ... equivalent relevant experience. + Experience with Medicare and Medicaid and/or health insurance , a plus. **License/Certifications:** + Certified Professional… more
- State of Colorado (Denver, CO)
- …through various channels but primarily though www.stopfraudcolorado.com. The position conducts investigations of consumer fraud and violations of other Consumer ... prosecution or other compliance regulation + Knowledge and experience investigating consumer fraud or financial investigations + Certified Fraud Examiner… more
- American Express (Ayer, MA)
- …Reporting to the Director of Investigations , the Special Agent Cyber Fraud Investigations is responsible for supporting global investigations into ... crimes. + Demonstrated experience in driving innovative approaches to cybercrime/financial fraud investigations . + Experience working across multiple lines of… more
- CVS Health (Tallahassee, FL)
- …and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). ... Bring your heart to CVS Health . Every one of us at CVS ...investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct… more
- Huntington National Bank (Columbus, OH)
- Description Summary: The Fraud Investigator role within the Fraud Investigations Departments at Huntington National Bank is responsible for investigating ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance coverage, wellness program, life and disability insurance… more
- Guidehouse (New York, NY)
- …and/or life science companies. + Experience with internal investigations of fraud and/or bribery and corruption for public health agencies, payer/providers, ... You Will Do** **:** Guidehouse has an aggressive growth strategy for its Health Financial Crime, Fraud , and Investigative Services practice. Guidehouse is… more
- MyFlorida (Miami, FL)
- …provides analytical support for attorneys and investigators in Florida-specific and multistate health care fraud investigations and litigation matters. An ... of damages models for use in Florida-specific and multistate health care fraud investigations and...and one Personal Holiday each year. + State Group Insurance coverage options, including health , life, dental,… more
- Elevance Health (Atlanta, GA)
- **Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal ... live within 50 miles of one of our Elevance Health PulsePoint locations. **Hybrid Workplace Strategy:** 1-2 days in...Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- NBT Bank (Lakeville, CT)
- Pay Range: $27.48 - $36.65 The Senior Fraud /AML Investigator will work fraud and money laundering cases as assigned by the BSA Officer and Security Officer as ... well as cases arising from independent reviews of transaction and fraud monitoring reports. Education and Experience: + 3 years experience investigating various… more
- Ally (Lansing, MI)
- …position. **The Work Itself** * Maintain, monitor, and test an excellent Fraud Prevention, Detection, and Investigations program supporting Ally's Deposits ... investigations and related investigative review processes. * Build fraud awareness, education, and referral/alert notification processes. * Communicate portfolio… more
- TEKsystems (Honolulu, HI)
- …development, documentation, and implementation of policies and procedures to streamline fraud operational workflows and account investigations . * Provide ... process. * Document customer interactions meticulously to support ongoing investigations and future fraud prevention efforts. *...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Molina Healthcare (Columbus, OH)
- …**Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power ... Experience** * Minimum of 8-10 years relevant experience in special investigation units, Insurance Fraud and Abuse, Payment Integrity Program, Law Enforcement or… more
- Sallie Mae (Newark, DE)
- …for the future of education. **What You'll Contribute** The Senior Manager, Fraud Risk Management will be responsible for developing and implementing a comprehensive ... Fraud Risk Management framework to effectively minimize risk and...strategies and frameworks. + Experience in conducting risk assessments, investigations , and reporting on financial crimes incidents. + Experience… more
- American Airlines (Dallas, TX)
- …Credit Union. The role is responsible for providing administrative support for fraud investigations for American Airlines Credit Union members. **What you'll ... the Legal Department fraud analyst to determine fraud trends and provide helpful information for investigations...than 6,800 daily flights across our global network. + Health Benefits: On day one, you'll have access to… more
- UMB Bank (Kansas City, MO)
- …abuse (including Credit Card 'Bust Out', OLB Scams. + Conduct detailed investigations and reporting on new account origination fraud , first-party abuse ... company sponsored benefit plan including medical, dental, vision, and other insurance coverage; health savings, flexible spending, and dependent care… more
- TEKsystems (Austin, TX)
- …Administration, Justice, or Accounting). 3+ years of work experience in online fraud investigations , trust and safety, and/or cybersecurity. Experience in data ... org and is responsible for scaled workflows and actor-level investigations that protect people from financial fraud ....- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Umpqua Bank (Tigard, OR)
- …lines of the bank to prevent and reduce operational losses. + Conducts investigations to identify internal fraud , customer account fraud transactions, ... Reports based on investigation analysis and findings. + Analyzes customer accounts during investigations for fraud . + Interacts with all levels of law… more
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