- Ally (Austin, TX)
- …constantly evolving, so shouldn't your opportunities be, too? **The Opportunity** The Fraud Investigations Senior Supervisor oversees a fraud investigation ... * Bachelor's Degree in Criminal Justice preferred. * 3+ years fraud investigations AND SAR experience with leadership/investigations/ operations experience in… more
- Ally (Austin, TX)
- …role will lead the design, implementation, and execution of a robust Fraud Investigation Recovery framework for deposit operations . Responsible for implementing ... various internal and external teams * 5+ years of experience in fraud investigations and SARs with leadership/investigations/ operations experience in financial… more
- Humana (Oklahoma City, OK)
- …and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join the Oklahoma Medicaid Team. This ... fraud , waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...to Humana's Oklahoma Medicaid line of business. As the Senior Fraud and Waste Investigator, you will… more
- Citigroup (Jacksonville, FL)
- …and development of advanced statistical models + Proven experience in the Investigation and Fraud claims process + Experience in trend analysis and alerts in ... The Fraud Ops Sr Analyst is a senior...Family Group:** Operations - Services **Job Family:** Fraud Operations **Time Type:** Full time **Primary… more
- Citizens (Johnston, RI)
- …Citizens Fraud & Claims Organization is seeking a dynamic and experienced Senior Fraud Operations Manager to lead our OLB and Mobile Fraud ... Description Job Title: Senior Fraud Operations Manager - OLB and Mobile Fraud Detection Description:… more
- JPMorgan Chase (Columbus, OH)
- …innovative and inclusive customer experiences. As a Service Design Senior Associate in Claims , Disputes, Fraud Operations , you will play a pivotal role ... in developing end-to-end customer and employee experiences by leveraging your advanced knowledge of service design principles. As a core contributor participate in the execution of service strategies designed to serve our employees' and customers' experiences… more
- UMB Bank (Kansas City, MO)
- …training to provide extensive UMB and financial knowledge, the Fraud Enterprise Operations team consists of 3 teams; Prevention, Claims and Data Strategy ... clients and internal partners to escalate, investigate, and resolve fraud claims multi payments channels and mitigate...with their manager to develop roadmaps for opportunity within Fraud Operations and beyond. **_How you'll spend… more
- State of Massachusetts (Boston, MA)
- …you'd do:* Claims Examiner/Job Service Representative I, who reports to the Senior Manager of Benefit Operations & Program Integrity is based in Boston, ... * Claims Examiner/Job Service Representative I| Department of Family...system testing/reporting as required. 13. Intake reports of potential fraud through the Department's Fraud Hotline. 14.… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Senior Claims Investigator to play your part in that transformation. It's an opportunity ... and efficiency. How you will create an impact The Senior Claims Investigator is responsible for all...with insureds, lawyers, corporate employees, vendors, police and relevant fraud bodies. + Complete targeted claims reviews… more
- New York State Civil Service (Melville, NY)
- …to prevent and mitigate fraud . DCI is comprised of four separate teams: Claims Fraud , Provider Fraud , Policyholder Fraud and Data ... NY HELP No Agency Insurance Fund, State Title Investigator 1, Senior Investigative Officer Occupational Category Other Professional Careers Salary Grade NS… more
- State of Massachusetts (Boston, MA)
- …property. The OIG is an independent state agency charged with preventing and detecting fraud , waste, and abuse in the use of public funds and public property. The ... into three bureaus: Specialty & General Government, Legal & Compliance, and Operations , Training & Publications. The bureaus focus on specific agencies, issues, or… more
- State of Minnesota (St. Paul, MN)
- …to detect fraud , abuse, over-utilization, and error in health care claims . AND Experience must demonstrate the following: + Develop criteria and parameters used ... **Working Title: Senior Investigator** **Job Class: Human Services Program Representative...of MN DHS Licensed providers + An understanding of claims processing operations , edits, and CPT coding… more
- Wells Fargo (Minneapolis, MN)
- …the seamless execution, compliance, and innovation of payment processes across our global network. ** Fraud and Claims Management:** + Fraud and Claims ... Wells Fargo is seeking talent to join the Global Operations team under the Chief Operating Office (COO) organization...prevent victim and perpetrator fraud , processes check fraud and Automated Clearing House (ACH) claims ,… more
- Elevance Health (Atlanta, GA)
- …to worksite and other locations as necessary + BA/BS preferred + Medical claims review with prior health care fraud audit/investigation experience preferred + ... **Nurse Audit Senior - Payment Integrity Complex and Clinical Audit**...and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review.… more
- Geisinger (Danville, PA)
- …teams. Develops and directs the prevention, detection and investigation of anti- fraud , waste and abuse (FWA)program processes and oversight and coordination of ... activities. Ensures all regulatory requirements are met including the completion of annual fraud plans and reports. Acts as a point of contact for collaboration with… more
- Otsuka America Pharmaceutical Inc. (Augusta, ME)
- **Position Overview:** The Senior Director, MSAT Biologics provides strategic and technical leadership for all late-stage and commercial manufacturing processes for ... supporting the company's portfolio, focusing on technical oversight of CDMO manufacturing operations . + Build, lead, mentor, and manage the MSAT team, fostering a… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …the Senior Manager of Process, Policy & Governance reporting to the Senior Director, Procurement Operations ; your primary focus will be the maintenance and ... enhancement of Otsuka's Procurement operations , processes and policies in support of Otsuka's North America portfolios. This role will have responsibility for… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …and routers implementing VLANs, routing protocols, LACP, etc. + Experience in supporting IT operations in compliance with 21 CFR Part 11, COBIT 4, and J-SOX + ... + 15 years of IT related experience **Preferred:** + CCIE or relevant senior level certifications + Expert knowledge of firewall configuration, ACL's and network… more
- Sedgwick Government Solutions (Charleston, SC)
- Job Details Senior Care Associate Team Lead (Remote) Strong Internal 2025-1455 Charleston, SC, USA Medical Services Full Time Description **Overview** Are you eager ... Care Associates in the Central Management Unit (CMU). The Senior CMU, NVRS Care Associate Team Lead oversees daily... CMU, NVRS Care Associate Team Lead oversees daily operations and performance of the CMU team, providing leadership… more
- City of New York (New York, NY)
- …to protect the City fisc, and to represent the City in the array of claims that arise in its operations . Division attorneys handle matters involving virtually ... 10 years of litigation experience for the position of Senior Counsel in the Affirmative Litigation Division. The Division...worker protection matters, civil enforcement of the Administrative Code, fraud and false claims act cases, and… more
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