- Wells Fargo (San Antonio, TX)
- …or consultants, and engage management, vendors or related functional areas associated with fraud and claims investigations + Identify and recommend ... **About this role:** Wells Fargo is seeking a Fraud & Claims Operations Manager...in hiring talent **Required Qualifications:** + 4+ years of Fraud Claim Investigations or Policy Violations, Risk… more
- Bank of America (Charlotte, NC)
- …years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Charlotte/Attorney-I Fraud Claims -and-At-Risk-Persons\_25028865-1) **Job ... Attorney - Fraud & Claims and At-Risk Persons...+ Supports company responses to government agency examinations and investigations , enforcement actions, private complaints, and litigation + Provides… more
- Citizens (Johnston, RI)
- …regulations and standards. Qualifications: + Experience: Extensive experience in either fraud detection management, fraud investigations , strategy or ... Description Job Title: Senior Fraud Operations Manager - OLB and...OLB and Mobile Fraud Detection Description: Citizens Fraud & Claims Organization is seeking a… more
- Citizens (Johnston, RI)
- Description The Manager of Fraud Risk Oversight will support the independent Risk Oversight of the Fraud and Claims divisions and all aspects of Fraud ... including the effectiveness of Fraud Strategy/Analytics, the efficiency of Fraud Alert Review and Investigations and effectiveness of Front-Line Controls… more
- Ankura (Chicago, IL)
- …to Life Sciences clients and external counsel through compliance, disputes, investigations and advisory services. The position has tremendous growth potential with ... be working with practice leadership to provide exemplary compliance, disputes, investigations and litigation support (eg, expert witness) services across the Life… more
- Truist (Orlando, FL)
- …analytical capabilities. Perform sophisticated analytics and investigations into large dollar claims and overdraft accounts as well as fraud trends through ... review the following job description:** Looking for a strong fraud fighter with experience in Deposit fraud ...work all hours scheduled, including overtime as directed by manager /supervisor and required by business need. **Travel** Minimal and… more
- Staples (Orlando, FL)
- …and programs in Supply Chain locations related to inventory loss, theft, and fraud . + Ensure appropriate internal risk controls are in place through the application ... of programs including data analysis, audits, training, and investigations . + Manage the Asset Protection Associate teams responsible for front line security in FCs… more
- EFI Global (Montgomery, AL)
- …decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global ... leader in engineering failure analysis, origin-and-cause investigations , environmental consulting, laboratory testing and specialty consulting. Our forensic… more
- EFI Global (Boston, MA)
- …decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global ... leader in engineering failure analysis, origin-and-cause investigations , environmental consulting, laboratory testing and specialty consulting. Our forensic… more
- Elevance Health (Roanoke, VA)
- …preferred. + Experience with FACETS strongly preferred. + Experience with Fraud , Waste, and Abuse preferred. + Claims auditing/editing experience ... and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:**...abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …as a result of claims audit or investigation. + Maintains awareness of fraud , waste and abuse laws and regulations and current industry changes that may impact ... clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours Mercy… more
- Travelers Insurance Company (Diamond Bar, CA)
- …. Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where ... all offset opportunities, including apportionment, contribution and subrogation. + Evaluate claims for potential fraud . Proactively manage inventory with… more
- CDM Smith (Raleigh, NC)
- …CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial ... data related to disaster-related claims , including property damage, business interruption, and other loss...other loss categories. The specialist will conduct thorough forensic investigations to identify discrepancies, detect potential fraud ,… more
- Elevance Health (Arlington, VA)
- …+ Reviews provider medical record documentation to determine if there is potential fraud , waste, or abuse that warrants further investigations . + Conducts ... audits, and participates in developing an investigation team that focuses on potential fraud , waste and abuse in the provider population. **How will you make an… more
- Elevance Health (Tampa, FL)
- …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- CVS Health (Somerset, PA)
- … investigations including, but not limited to: Internal/External theft, fraud , falsification of company records, misappropriation of company assets, safety ... employees, building, product, supplies, etc.), conducting internal and external investigations , overseeing Environmental Health and Safety programs, conducting operational… more
- Pilgrim's (Greeley, CO)
- …quality investigations through resolutions + Participate and lead with manager in training to cross-functional team. + Actively pursue professional development ... Development team and reports directly to Senior Ingredients & Nutrition Regulatory Manager . This role supports the development of food products by accurately… more
- Elevance Health (Overland Park, KS)
- …identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on ... fraudulent claims . Health insurance experience required with understanding of health...Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one… more
- Highmark Health (Albany, NY)
- …documentation. *Identifies potential fraud cases and forwards to Special Investigations Unit. E3. Adjusts claims : *Performs online transactions and/or ... inquires from subscribers, members, providers, internal and external customers; Adjusts claims . This is a bargaining unit position. The collective bargaining… more
- CVS Health (Patterson, CA)
- … investigations including, but not limited to: internal/external theft, fraud , falsification of company records, misappropriation + of company assets, safety ... employees, building, product, supplies, etc.), conducting internal and external investigations , overseeing Environmental Health and Safety (EHS) programs, conducting… more
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