- State of Colorado (Denver, CO)
- …and identify allegations that meet the statutory definition of insurance fraud . This position will conduct criminal investigations that include independent ... The Financial Fraud Unit exists to investigate and prosecute allegations of securities fraud and insurance fraud throughout the State of Colorado. This… more
- State of Colorado (Denver, CO)
- …state residents. WHAT YOU WILL DO The Senior Paralegal position will support two teams - Insurance Fraud and Securities Fraud - within the Financial Fraud ... Senior Paralegal (Legal Assistant II) - Financial Fraud Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5139989) Apply Senior Paralegal (Legal… more
- Sanford Health (Fargo, ND)
- …is required. Minimum 3 years' experience in health insurance investigation /audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) ... is required. - Minimum 3 years' experience in health insurance investigation /audit. - Master's Degree preferred -...for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies.… more
- DoorDash (Tempe, AZ)
- …Experience: + Google suite advance proficiency (sheets, docs, gmail, calendar) + Investigations experience ( fraud , insurance , law enforcement) Notice to ... About the Team The Fraud team reduces the cost of fraud and provides insights to protect our platform from would-be fraudsters. You'll help build a team from the… more
- Philadelphia Insurance Companies (Ewing, NJ)
- … investigations of suspect insurance claims and policy applications. Conduct insurance fraud investigations in accordance with applicable law and ... SIU to join our team! Summary : Evaluate referred insurance claims for potential insurance fraud...claims and applications referred to the SIU for possible fraud . Conduct database investigations , including use of… more
- USAA (Cheyenne, WY)
- …claims by investigating questionable, suspect claims activity in compliance with state insurance fraud -related laws and regulations and policies and procedures. ... Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. + Collects...with industry, law enforcement and other contacts involved in fraud investigation , detection, and prevention. + May… more
- General Dynamics Information Technology (Fairfax, VA)
- …**Public Trust/Other Required:** None **Job Family:** Ancillary Health **Skills:** Healthcare Fraud (Inactive), Insurance Fraud Investigations , ... , waste, and abuse schemes and conduct research and investigation of insurance policies, coding guidelines and...health care claims analysis + 8+ years' experience in fraud , waste, and abuse investigations + Certified… more
- Allied Universal (Provo, UT)
- …course + Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims + Proficient ... Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation ...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more
- MyFlorida (Tallahassee, FL)
- …Healthcare Fraud Investigator; Certified Financial Crimes Investigator; Certified Insurance Fraud Investigator; Certified Compliance and Ethics Professional, ... The candidate selected for this MHCPA position is responsible for conducting investigations and developing fraud , waste, and abuse referrals of providers… more
- Kemper (Doral, FL)
- …will coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement agencies. A laptop ... field as well as desk investigations of insurance claims referred to and accepted for investigation...Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified … more
- Allied Universal (Fargo, ND)
- …with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims + High school diploma with ... of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims +...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more
- MyFlorida (Tallahassee, FL)
- …Healthcare Fraud Investigator; Certified Financial Crimes Investigator; Certified Insurance Fraud Investigator; or Certified Compliance and Ethics ... well as a desire to innovate. The selected candidate will assist in conducting investigations and audits related to fraud , abuse, and waste through research and… more
- Point32Health (Canton, MA)
- …criminal justice Experience + Required (minimum): 1-3 years' related experience in health insurance fraud investigations . + Preferred: Related experience in ... Investigation Unit ("SIU") responsible for leading complex provider investigations related to fraud , waste, and abuse,...+ Paid time off + Employer-paid life and disability insurance with additional buy-up coverage options + Tuition program… more
- Zelis (Boston, MA)
- …and the personal interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute significantly to ... fraudulent activities by conducting comprehensive reviews of all internal and external fraud monitoring alerts, performing fraud investigations , and… more
- MyFlorida (Tallahassee, FL)
- …Healthcare Fraud Investigator; Certified Financial Crimes Investigator; Certified Insurance Fraud Investigator; Certified Compliance and Ethics Professional, ... involve travel-related activities from 1-15%. Successful completion of a criminal background investigation is a condition of employment. A good attendance record is… more
- Louisiana Department of State Civil Service (LA)
- …White-Collar Crimes, Violent Crime and Drug Unit, Sexual Predator Apprehension Team, and the Insurance Fraud Unit. The Criminal Division also serves: + Medicaid ... Division assists federal, state, and local agencies in the investigation and prosecution of a wide range of criminal...Fraud Control Unit: The Louisiana Medicaid Fraud … more
- Manulife (Boston, MA)
- …the global fraud risk management strategy. This role involves guiding fraud prevention, operations, and investigations to ensure alignment with corporate ... enhance the organization's capabilities. + Ensure the maturity and effectiveness of fraud detection schemes across insurance and asset management. _Business… more
- MyFlorida (Miami, FL)
- …COMPETITIVE EMPLOYMENT OPPORTUNITY CLASS TITLE: LAW ENFORCEMENT INVESTIGATOR II (SWORN INSURANCE FRAUD DETECTIVE) DIVISION: CRIMINAL INVESTIGATIONS DIVISION ... INSURANCE FRAUD CITY: MIAMI COUNTY:MIAMI-DADE The Criminal Investigations Division encompasses all law enforcement and forensic components residing within… more
- Humana (Dayton, OH)
- …+ Must reside in Ohio + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies ... 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… more
- MVP Health Care (Tarrytown, NY)
- …RN. + New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC ... a related field, and minimum of five years of insurance claims investigation experience; or five years...SIU personnel. + Keep abreast of Federal and State Anti- Fraud investigation and reporting requirements including HIPAA,… more