- Elevance Health (Richmond, VA)
- Anticipated End Date: 2025-07-31 Position Title: Clinical Fraud Investigator II - Registered Nurse and CPC - Carelon Payment Integrity SIU Job Description: Clinical ... Fraud Investigator II - Registered Nurse and CPC -...Performs in-depth investigations on identified providers as warranted. Examines claims for compliance with relevant billing and processing guidelines… more
- EPIC Brokers (Alpharetta, GA)
- …working for or with mid-size to large firms, and experience working company risk , contracts, and/or insurance policies or claims is also preferred. Candidates ... Greyling Insurance Brokerage & Risk Consulting, a division of EPIC, is a...looking to grow our team! JOB OVERVIEW: The Account Manager will be the primary client contact and will… more
- Professional Staffing Services Group (Orlando, FL)
- …with requestors and third-party vendors to resolve payment issues promptly. Mitigating Fraud Risk : Work closely with the Director and internal management ... Accounts Payable Manager - 2 year Contract role Location: Orlando,...reporting to identify opportunities for improvement and significantly reduce fraud risk within the AP workstream. Providing… more
- Harbinger Motors Inc. (Garden Grove, CA)
- …Hybrids. Harbinger: Familiar Form, Revolutionary Foundation. Job Overview As a Commodity Manager within the Supply Chain organization, you will lead the strategic ... Develop and execute commodity strategies that support scalability, innovation, and risk mitigation. Collaborate with Engineering and Supplier Quality to identify and… more
- The Travelers Indemnity Company (Morristown, NJ)
- …specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other ... assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life...to facts or allegations of each case. Consults with Manager on use of Claim Coverage Counsel as needed.… more
- Bank of America (Newark, DE)
- …at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Newark/Wealth-Management- Fraud Claims Sr- Fraud -Analyst\_25028343) ... Wealth Management Fraud & Claims - Sr. ...in a call center or a financial/banking center + Fraud Detection and Prevention + Credit Risk … more
- Citizens (Boston, MA)
- Description The Manager of Fraud Risk Oversight...and Claims divisions and all aspects of Fraud risk across the organization. Independent risk ... relationships across lines of defense to ensure all aspects of the Fraud Risk Management framework are delivered according to policy and business strategy. The… more
- Navy Federal Credit Union (Pensacola, FL)
- …are implemented and achieved + Oversee debit and credit recovery to ensure fraud claims are aligned with regulation time frames, meet compliance expectations, ... process improvement to elevate service performance, increase member experience quality, reduce fraud losses, minimize fraud risk , and maintain high… more
- Bank of America (Plano, TX)
- …increased the scope and complexity of effectively detecting, mitigating and monitoring ATO risk within the Bank's ecosystem. The Fraud Prevention and Detection ... capability roadmap development **Required Qualification:** + 4+ years of fraud , cyber, or risk analyst experience developing...Computer Science, Data Science, Statistics, or related field + Fraud or Claims background with focus on… more
- Elevance Health (Norfolk, VA)
- …Investigator Senior** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an ... **Clinical Fraud Investigator Senior** **Location:** _Hybrid1:_ This role requires...in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines… more
- Bank of America (Newark, DE)
- …include researching and analyzing of account activity to assess levels of risk and fraud . Job expectations include completing inbound and outbound ... a fast-paced, ever-changing environment with a strong focus on risk mitigation and client experience. + Comfortable taking inbound...as needed. **Desired Skills:** + Prior experience in Retail Fraud Servicing, Claims or Fraud … more
- Truist (Orlando, FL)
- …great analytical capabilities. Perform sophisticated analytics and investigations into large dollar claims and overdraft accounts as well as fraud trends through ... insights and deploy fraud rules to improve business outcomes and minimize risk and also provide consultation to business leaders and other stakeholders on how to… more
- AIG (Lenexa, KS)
- At AIG, we are reimagining the way we help customers to manage risk . Join us as a Claims Examiner II, Accident & Health to play your part in that transformation. ... Recognize and pursue subrogation where warranted and make appropriate Risk and Fraud referrals. + Increased responsibility...+ Increased responsibility with an expectation of managing higher claims volumes and assist manager with customer… more
- DXC Technology (Richmond, VA)
- …We are seeking a **Quality Analyst** with experience in **Life and Annuity Death Claims ** to join our growing team. This role will be responsible for performing ... + Conduct quality control reviews of Life and Annuity Death Claims payments and correspondence to ensure compliance with regulatory requirements and… more
- Peak Vista (Colorado Springs, CO)
- Manager of Compliance & Risk Summary Title:...the Compliance & Risk Management Programs, HIPAA, Fraud and Abuse, FTCA, False Claims , and other ... Under the direction of the Director of Compliance & Risk Management, the Manager of Compliance &...monthly, quarterly, and annual C ompliance reports and insurance claims updates for the Board of Directors and provides… more
- Grant Thornton (Los Angeles, CA)
- As a Process Risk Manager , you will have the opportunity to grow and contribute to our clients' success by helping them identify and understand their business ... role in both proactively addressing and responding to these risks within our Risk Advisory Practice, supported by the resources and environment necessary for your… more
- Ankura (Chicago, IL)
- …Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice ... . Be a key contributor to project delivery teams . Serve as project manager for client services, including large and complex engagements . Support expert witness… more
- Sedgwick (Jacksonville, FL)
- …subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective relationship with internal and external ... Fortune Best Workplaces in Financial Services & Insurance Account Manager **PRIMARY PURPOSE** **:** To manage claim caseload of...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Amazon (Seattle, WA)
- …Design innovative solutions such as closed-loop mechanisms for warranty claims and cost-effective concession strategies. * Analytics & Reporting: Establish ... and present comprehensive performance metrics to stakeholders at all levels. * Risk Management & Protection: Ensure the A-to-z Guarantee program effectively protects… more
- Capital One (Mclean, VA)
- …products associated with the resolution of credit card Fraud and Dispute claims . This Product Manager will partner closely with the Business Analyst team ... Fraud Product-** Will be responsible for managing the Claims System of Record (CSOR) and Fraud ...Analysts to identify areas of opportunity to reduce cost, risk or manual processes. **Capital One Product Framework** In… more
