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Healthcare Fraud Investigator Jobs

Healthcare Fraud Investigator Jobs
By Advize At United States

As Advize's work in the FWA world grows, so must our team. This position will be in our internal Special Investigations Unit (SIU) where you will conduct Medicaid fraud, waste, and abuse (FWA) ...

Fraud Investigator Jobs
By Advize At Indiana, United States

As Advize's work in the FWA world grows, so must our team. This position will be in our internal Special Investigations Unit (SIU) where you will conduct Medicaid fraud, waste, and abuse (FWA) ...

Senior Fraud Investigator Jobs
By MUFG At , Tampa $70,000 - $85,000 a year
Typically requires 3+ years of direct experience in fraud detection
Experience with industry-leading fraud tools/systems.
Excellent communication skills and attention to detail.
Strong analytical, problem solving, and decision-making skills.
Familiarity with Actimize, and digital fraud attributes and systems. Ability to disseminate information accordingly.
Ability to recognize and have a familiarity with common red flags and fraud trends regarding online banking/online payments.
Visa Fraud Investigator Jobs
By Charles Schwab At , Lone Tree $64,700 - $80,000 a year
Strong verbal and written communication skills
Working knowledge of Regulation E
Demonstrated work history of working well with others in a team environment
Familiarity with financial industry operations
In addition to the salary range, this role is also eligible for bonus or incentive opportunities.
Medicaid Fraud Investigator (Investigator 3)
By Department of Justice At , Portland $4,465 - $6,851 a month
Possess excellent analytical, communication, and organizational skills.
Experience interviewing witnesses and suspects, who are occasionally uncooperative and hostile.
Experience writing interview and investigative reports
Experience testifying in administrative, civil, or criminal proceedings.
Experience working as part of a multidisciplinary team.
Experience reviewing and analyzing financial records.
Fraud Investigator I Jobs
By BankUnited At , Miami Lakes, 33016
May assist the Fraud Operations Unit with fraud monitoring and fraud analysis report management if needed.
Perform any other assignments as directed by Fraud Investigations Team Lead or the Fraud Investigations Unit Manager.
Must have experience in the areas of check fraud, Identity Theft, ATM/Debit card fraud, bank operations and other related fraud
Working knowledge of bank products, services, bank systems and transaction types.
Strong verbal and written communication skills.
Detail oriented with strong research and problem solving skills.
Fraud Investigator (Social Services)
By City of Portsmouth At , Portsmouth $49,952 - $71,931 a year
Education, Experience & Special Requirements
MINIMUM QUALIFICATIONS OR STANDARDS REQUIRED TO PERFORM ESSENTIAL JOB FUNCTIONS
General Statement of the Job & Essential Functions
Fraud Investigator Jobs
By Silver State Schools Credit Union At , Las Vegas, 89119 $24.34 - $26.13 an hour
Research, recommend and implement fraud loss mitigation techniques to management.
Special projects, research, analysis or other duties as assigned by the Manager.
I will earn respect and build trust by acting with integrity in every situation.
I will understand my role in supporting the team to achieve our purpose.
I will focus on people over products and build lasting relationships.
I will take ownership and accept responsibility.
Anti-Fraud Investigator Jobs
By Central Mutual Insurance Company At , Alpharetta, 30009
Effective organization and time management skills with the ability to work under pressure and adhere to project deadlines
Complies with State Requirements for reporting questionable claims and documented within Case Manager
Bachelor’s Degree or in-lieu of degree equivalent education, training and work-related experience
5+ years of experience with a law enforcement agency/SIU group and/or multi-line claims handling experience within the insurance industry
Possess prior experience in the investigation of insurance fraud
Solid knowledge of the claims/SIU policies and procedures; exhibits sound interpretation of policies & procedures in investigating and resolving claims
Fraud Investigator Jobs
By Zions Bancorporation At , Midvale, 84047 $43,000 - $62,000 a year
Makes recommendations for closing account relationships to the Investigations management. Escalates identified risks to team leadership.
Uses various bank systems to conduct research of customer transaction activity including the case management system.
Communicates with branch, department managers, BSA Officers, and frontline groups as necessary, in researching and investigating cases.
Good analytical skills, customer service and communication skills, both verbal and written.
Ability to manage deadlines, be organized, detail-oriented and high degree of accuracy.
Strong PC skills desired with an emphasis in MS Excel and Word.
Fraud Investigator Associate Jobs
By Arkansas Blue Cross and Blue Shield At ,
Arkansas Blue Cross is only seeking applicants for remote positions from the following states:
Previous health insurance investigation experience desirable.
Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
Understanding of claims processing systems and medical claims coding.
Proficiency working with MS Office Suite, such as Word and Excel.
Fraud Investigator I Jobs
By Navy Federal Credit Union At , Winchester, 22602, Va

Overview To identify, review, investigate fraud activity, claims/cases and risk exposures from various delivery channels. Review transactional activities, internal/external inquiries, and ...

Fraud Investigator Lead- Express Scripts - Remote
By The Cigna Group At , Hartford, 06152, Ct $63,700 - $106,100 a year

The Fraud Investigator Lead position is responsible for the development, investigation, and presentation of complex fraud, waste and/or abuse cases. Using analytical skills, in-depth prescription drug ...

Healthcare Fraud Investigator-Work At Home
By The Cigna Group At United States
Minimum 3 years' experience in health insurance investigation/audit
Clear and concise verbal and written communication skills.
Strong computer skills are required - Excel, Access and Word
Accredited Health Care Fraud Investigator (AHFI) certification and Certified Fraud Examiner (CFE) preferred
Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations
Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies.
Fraud Investigator Jobs
By Frontwave Credit Union At Oceanside, CA, United States
Presents reports and recommendations to management.
We create memorable experiences for life.
Competitive pay, 401k matching, mortgage and auto discounts.
9-27 days of PTO per year (based on tenure) and 10 paid holidays.
Affordable medical, dental, vision health plans, and Flexible Spending Account.
Employee Assistance Program with a variety of services.
Healthcare Investigator Jobs
By Advize At United States

CFE and AFHI are preferred but not required.

Fraud Investigator: West Tennessee
By Tennessee Comptroller of the Treasury At West, TN, United States

The Tennessee Comptroller of the Treasury is seeking an Investigator to investigate allegations of fraud, waste, and abuse in government and publicly funded entities, primarily in Fayette, Lauderdale, ...

Healthcare Fraud Intake Investigator - Entry Level - Hourly
By Qlarant At Los Alamitos, CA, United States
Refers all potential adverse decisions to the Lead Investigator/Manager.
Experience in healthcare programs or fraud investigation/detection;
Enters investigative information into the case tracking systems and will meet with Lead Investigators to assign investigations to the Investigative team.
Works with the team to prioritize complaints for investigations.
Places potential fraudulent providers on prepay review and monitor adjudication of claims.
Analyzes data for appropriateness of fraud, waste and abuse issues in accordance with pre-established criteria, requesting additional documentation if necessary.
Fraud Investigator Jobs
By Philips At Cambridge, MA, United States
Support and lead multiple complex fraud investigations, document findings and report outcome to the senior management.
Ability to manage concomitant complex tasks and excellent interviewing and report writing skills.  
You have a Bachelor degree (accounting, finance, law or equivalent) and good MS Office skills.
Your skills include understanding of business information and financial reporting systems, accounting and auditing standards and procedures.
Read more about our employee benefits.
Act as representative for FICS and interact and engage with senior stakeholders in your area of responsibility.
Fraud Investigator Jobs
By Peyton Resource Group At San Antonio, Texas Metropolitan Area, United States
Strong written and verbal communication skills - 2 years
Identifies and manages existing and emerging risks that stem from business activities and the job role.
Responds to security threat incidents and experience feedback, performing routine analysis using security tools.
Assists in using the discoveries from the incident response process to make basic improvements to the existing detection capabilities.
Determining root cause analysis - 1 year
Detail oriented research to include fraud detection analysis - 1 year