- City of New York (New York, NY)
- …stipulated in their agreement to repay. Claims &Collection is recruiting for (4) four Fraud Investigator II to function as a Senior Fraud Investigator ... Job Description Claims and Collections pursues monetary recoveries owed to...and one year of satisfactory, full-time experience as an investigator as described in "1" above; or 3. A… more
- Allied Universal (Billings, MT)
- …plans, employee assistance programs, and exclusive perks. Allied Universal(R) is hiring a Claims Investigator . Claim Investigators validate the facts of loss for ... + One or more of the following professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator… more
- Allied Universal (Los Angeles, CA)
- …+ One or more of the following professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... programs, and exclusive perks. Allied Universal(R) is hiring a Claims / SIU Investigator . Claims ...extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting… more
- AIG (Atlanta, GA)
- …reimagining 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 ... efficiency. How you will create an impact The Principal Claims Investigator is responsible for all aspects...with insureds, lawyers, corporate employees, vendors, police and relevant fraud bodies. + Complete targeted claims reviews… more
- USAA (Dallas, TX)
- …you will help protect USAA and our members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact ... + Applies advanced knowledge of state laws and regulations pertaining to insurance fraud in investigating claims . + Processes large quantities of unstructured… more
- SMBC (Sacramento, CA)
- …the journey to deliver an exciting concept of evolved banking. **SUMMARY:** As a Fraud Investigator , you will investigate and research cases of identified ... fraud rings and patterns, assist victims in resolving fraud events, and denying fraud claims...as false through investigation. A primary responsibility of a fraud investigator at Jenius Bank is recovery… more
- TEKsystems (West Des Moines, IA)
- …(CFE) (preferred), Certified Fraud Specialist (CFS) or Certified Insurance Fraud Investigator (CIFI) and/or Certified Anti-Money Laundering Specialist (CAMS) ... Compliance Oversight and Financial Crimes team is looking for Compliance Analyst I investigator to join the team. This individual will be responsible for conducting… more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will ... oversee the monitoring and enforcement of the fraud , waste, and abuse (FWA) compliance program to prevent...closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the… more
- Elevance Health (Woburn, MA)
- **Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will ... **Hybrid Workplace Strategy:** 1-2 days in office per week The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities… more
- Manulife (Boston, MA)
- …Machine Learning / AI techniques and solutions to detect, capture and proactively prevent fraud , waste & abuse within the LTC claims process. You will partner ... with all squads to drive savings associated with fraud , waste & abuse. The LTC Investigator will conduct desktop investigations of high complexity related to LTC… more
- CareFirst (Columbia, MD)
- …**Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) and + Certified Expert Coder-AHIMA ... anti- fraud software analysis, and appropriately sourced reference materials. Investigator ensures timely maintenance and organization of case file documentation… more
- MyFlorida (Orlando, FL)
- …in 409.920, Florida Statutes. These matters include but are not limited to fraud against the Medicaid Program, false claims against the Medicaid program, ... LAW ENFORCEMENT INVESTIGATOR II - 41001050 Date: Oct 31, 2024...Statutes. These matters include but are not limited to: Fraud against the Medicaid Program, false claims … more
- USAA (Boston, MA)
- …our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and ... on any questionable or suspect first or third part claims . + Participates in the development of fraud... claims . + Participates in the development of fraud prevention strategies. + Applies knowledge of P&C insurance… more
- State of Georgia (Fulton County, GA)
- …Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the recruiting process ... Nurse Investigator Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/51086/other-jobs-matching/location-only) Hot...will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the direction of the… more
- EFI Global (Denver, CO)
- …commercial buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** **Investigates assigned claims suspected of insurance fraud , this includes large ... grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony,...loss, large fire loss, and multiple claims .** **Ensures that assigned cases are investigated and reported… more
- EFI Global (Memphis, TN)
- …buildings or residences. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Investigates assigned claims suspected of insurance fraud , this includes large loss, ... grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony,...large fire loss, and multiple claims . + Ensures that assigned cases are investigated and… more
- Elevance Health (Nashville, TN)
- ** Investigator II - Carelon Payment Integrity** **Location** : The ideal candidate will live within 50 miles of one of our OH, TN, IN, or NJ offices and will work on ... determined to recover, eliminate, and prevent unnecessary medical-expense spending. ** Investigator II** is responsible for the identification, investigation, and… more
- Elevance Health (Columbus, GA)
- **Senior Investigator ( Investigator Sr)** _Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... recover, eliminate, and prevent unnecessary medical-expense spending. The **Senior Investigator ** is responsible for the independent identification, investigation and… more
- US Agency for International Development (Washington, DC)
- …submit your application package. OIG is responsible for preventing and detecting fraud , waste, abuse, and violations of law, and for promoting economy, efficiency, ... and Millennium Challenge Corporation (MCC). Responsibilities As a GS-13 Criminal Investigator you will: Conduct complex and large-scale criminal, civil, and… more