Fraud Investigator - United States

This position entails providing direction to a staff of investigators to identify and research issues of potential fraud waste and abuse. This role requires proven leadership skills in-depth knowledge of the Medicare Program as it pertains to reviewing claims and provider behavio ...

+ Fraud investigation specialist responsible for investigating fraud cases supporting complex high severity incidents. Collaborate cross functionally analyze patterns recommend policy product improvements participate in postmortem on major fraud events drive fraud awareness acros ...

We are looking to add a Fraud Investigator Admin Action Specialist to our SGS team of talented professionals. · ...

Performs evaluation and development of leads, complaints, and/or investigations to verify allegations of potential fraud. · ...

The Manager of Special Investigation Unit leads organizational efforts to detect, investigate and prevent healthcare fraud by applying advanced fraud-detection methods, compliance strategies and deep knowledge of healthcare operations. · ...

We are seeking a skilled SIU Field Investigator to join our team at Presbyterian. · This role supports Program Integrity Department initiatives and is responsible for conducting announced and unannounced provider onsite audits related to suspected or actual healthcare fraud, wast ...

Job summaryGeneral Motors Insurance is launching an innovative Insurtech venture aimed at transforming the auto insurance industry through connected vehicle data and advanced technology. · Drive innovation by integrating advanced AI tools and techniques as well as common vendor t ...

This position will be posted until filled. The Auto Insurance Fraud Intelligence Analyst (FIA) will play a critical role in the identification and mitigation of emerging fraud trends targeting General Motors Insurance Company (GMIC) and its platforms. · Serves as subject matter r ...

The Amivero Team will work with the federal government to develop fraud analytic models that identify suspicious activity for further investigation and possible intervention. · ...

The Program Integrity Analyst III performs evaluation and development of leads, complaints, and/or investigations to verify allegations of potential fraud. · ...

The Medicaid Fraud Control Unit (MFCU) is charged with investigating and prosecuting fraud in Medicaid billing schemes and nursing home abuse. · Collect, compile, analyze, and interpret trends or patterns in complex medical data sets. · Formulate analyses and prepare reports. · ...

We are a leader in fraud prevention and AML compliance. · We have hubs in the Bay Area, NYC, Austin, and Toronto. · ...

An AML Specialist will perform research and analysis of Navy Federal account activity, identify red flags, suspicious activity, and potential fraud schemes. · • Conduct complex analysis into fraudulent transactions · • Create Suspicious Activity Reports (SARs) · • Maintain knowle ...

Perform research and analysis of Navy Federal account activity to identify red flags suspicious activity and potential fraud schemes. · Conduct complex analysis into fraudulent transactions including account takeovers identity theft synthetic identities and other emerging fraud t ...

As Fraud/Security Specialist, you will investigate and research illegal activities to mitigate losses and provide a positive customer experience. · ...

As a Fraud/Security Specialist, you will experience all aspects of German American Bank's culture and values while working with internal and external customers to recommend and perform appropriate actions required to mitigate losses and provide a positive customer experience. · ...

The SIU Investigator conducts field and remote investigations involving insurance claims.This is a part-time position requiring schedule flexibility. · Conduct SIU investigations across multiple insurance claim types · Identify fraud indicators, compensability issues, and materia ...

The Claims team has an opportunity for a SIU Investigator. The Special Investigator investigates and identifies questionable and suspicious claims, · Conduct timely investigations including recorded statements and interviews · Provide timely status updates · ...

+Job summary+This is a hybrid work remote role. · +Oversee the strategic direction and function of Government and Commercial Programs within the Advize operations line of business including P&L oversight to achieve organizational goals · ...

+We are a leader in fraud prevention and AML compliance. Our platform uses device intelligence, behavior biometrics, machine learning, and AI to stop fraud before it happens. · We have hubs in the Bay Area, NYC, Austin, · Toronto. However, · we maintain a remote-first work cultur ...