- US Customs and Border Protection (West Palm Beach, FL)
- …Patrol Agents may select from an array of federal employment benefits that include health and insurance plans, a generous annual and sick leave program, and ... while serving as a state, federal, or military law enforcement official. Leading investigations of fraud , contraband, criminal activity, threats to our nation,… more
- US Customs and Border Protection (Sierra Blanca, TX)
- …Patrol Agents may select from an array of federal employment benefits that include health and insurance plans, a generous annual and sick leave program, and ... utilizing intelligence information to track illegal operations and/or contraband. Leading investigations of fraud , contraband, and/or illegal operations to… more
- Nevada System of Higher Education (Las Vegas, NV)
- …to base salary, employees enjoy a comprehensive benefits package that includes:Comprehensive Health Insurance : includes health , dental, vision, and life ... planning, and development of the annual audit plan. Lead investigations of alleged fraud , misuse of resources,...annual audit plan. Lead investigations of alleged fraud , misuse of resources, or significant control weaknesses. Provide… more
- MVP Health Care (Rochester, NY)
- …to MD or RN. + New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or ... At MVP Health Care, we're on a mission to create...if you have a passion for problem solving and investigations , commitment to compliance and ethical standards and dedication… more
- Highmark Health (Montgomery, AL)
- …**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
- Guidehouse (Richardson, TX)
- …gain employment with our rapidly growing firm. Guidehouse is seeking experienced Fraud Investigations Analyst's to conduct, identify, and investigate potential ... document and escalate such matters. The responsibilities of the Fraud Investigations Analyst will include, but are...workplace. Benefits include: + Medical, Rx, Dental & Vision Insurance + Personal and Family Sick Time & Company… more
- State of Colorado (Denver, CO)
- …Office about those complaints. While your primary responsibility will be managing our fraud filing complaint investigations and processes, you will also have the ... and businesses affected by fraudulent business filings. In addition to managing our fraud filing complaint investigations , you will also be responsible for other… more
- Sanford Health (Fargo, ND)
- … health insurance investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud ... in health insurance investigation/audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud … more
- Columbia Bank (Tigard, OR)
- …able to provide subject matter expertise and leadership in the field of AML and fraud investigations as well as understanding the risks associated and types of ... Provide oversight and support services for groups that impact FID related to fraud investigations and AML transaction monitoring, process and policies. + Working… more
- Zelis (St. Petersburg, FL)
- …for payment transaction, ACH enrollment, and provider verification. + Oversee fraud investigations , root cause analyses, and escalations, ensuring timely ... PINS). As the Fraud Manager, you will be responsible for overseeing fraud detection strategies, leading complex investigations , and enhancing fraud … more
- Humana (Oklahoma City, OK)
- …part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the ... fraud , and member abuse cases to the Oklahoma Health Care Authority (OHCA) and other duly authorized enforcement...be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge… more
- Concentrix (Austin, TX)
- …Diploma or GED required + 1- 2 years of financial or payment fraud / investigations experience required + Additional experience in data analysis and technical ... Job Title: Fraud Analyst - VR Developer Support (Onsite) Job...intelligence, and third party private intelligence. + Execute complex investigations to understand how abuse is occurring and implement… more
- Elevance Health (Chicago, IL)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... by law._ **Carelon Payment Integrity** is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to… more
- American Express (New York, NY)
- …false positives and improve overall detection efficiency. + Partner closely with Fraud Investigations , Operational Risk, and Compliance to ensure analytical ... controls. + Provide analytical support and insights during internal fraud investigations and incident reviews. + Work...you and your loved ones' physical, financial, and mental health , as well as providing the flexibility you need… more
- American Express (Charlotte, NC)
- …Strategy, Investigations and Technology teams, the Director ensures that fraud alerts are timely, accurate, and actionable, while minimizing false positives and ... Operations is responsible for overseeing the daily operations of internal fraud detections systems, ensuring the effective monitoring of insider threats and… more
- Health Care Service Corporation (Chicago, IL)
- …healthcare fraud investigative experience. + Familiarity with laws applicable to health care fraud . + Ability to develop effective liaison relations which ... and concise verbal and written communication skills. **PREFERRED REQUIREMENTS:** + Accredited Health Care Fraud Investigator + Certified Professional Coder +… more
- Charles Schwab (Southlake, TX)
- …such as law enforcement, APS agencies, state securities regulators. + Knowledge of fraud investigations tools. Examples include: FRA, CLEAR or Lexis Nexis. + ... **Your opportunity** Located within the Fraud Risk Management section of Financial Crimes Risk...leave and family building benefits + Tuition reimbursement + Health , dental, and vision insurance What's in… more
- ManpowerGroup (Tempe, AZ)
- … Investigations Group supporting critical initiatives in anti-money laundering and fraud investigations . The ideal candidate will have strong analytical ... the financial services industry, is seeking an AML / Fraud Analyst to join their team. As an AML...various channels. + Work assigned cases daily and conduct investigations on financial crime transactions or policy violations. +… more
- American Express (New York, NY)
- …will manage one Rules Analyst and collaborate closely with partners across Fraud Analytics, Investigations , Technology, and Operational Risk to maintain ... of American Express. **Position Summary** The Senior Manager, Internal Fraud Rules Development plays a key leadership role within...you and your loved ones' physical, financial, and mental health , as well as providing the flexibility you need… more
- American Express (Charlotte, NC)
- …define the future of American Express. **Position Overview** The Director of Internal Fraud Detection Analytics leads the analytical engine that powers our internal ... fraud prevention strategies - designing, testing, and optimizing advanced...with partners across Enterprise Risk, Operational Risk, Compliance, and Investigations to inform and refine detection priorities. + Serve… more
