- Elevance Health (Gilbert, MN)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is ... **Clinical Fraud Investigator II - Registered Nurse...control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions… more
- State of Georgia (Fulton County, GA)
- Investigator - Medicaid Fraud Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/67636/other-jobs-matching/location-only) Hot ... Office of the Attorney General Department of Law Medicaid Fraud Division - Investigator The mission of...the necessary documents to identify and investigate health care fraud and patient abuse, including medical records,… more
- City National Bank (Phoenix, AZ)
- * FRAUD INVESTIGATOR SPECIALIST* WHAT IS THE OPPORTUNITY? Responsible for performing and documenting through root cause analysis on clients' transactions ... activities that impact CNB's clients, and corporate losses. Additionally, the Fraud Investigator will quarterback internal events and investigation activities… more
- Bank of America (Pennington, NJ)
- GFCC Investigator (Brokerage) - Specialized AML & Fraud Charlotte, North Carolina;Jersey City, New Jersey; Pennington, New Jersey; Dallas, Texas; Chicago, ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Charlotte/GFCC- Investigator --Brokerage Specialized-AML Fraud \_25031328) **Job Description:** At Bank… more
- Elevance Health (Norfolk, VA)
- **Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... accommodation is granted as required by law. The **Clinical Fraud Investigator II** is responsible for identifying...control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare… more
- CVS Health (Hartford, CT)
- …and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In ... will manage complex investigations into suspected and known acts of healthcare fraud , waste and abuse (FWA). **Key Responsibilities** + Conduct high level, complex… more
- Guardian Life (New York, NY)
- …+ Ability to spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and manual exception reports and ... filings, including, but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business partners. Assists in… more
- US Bank (Knoxville, TN)
- …the following (some may vary based on role, location or hours): + Healthcare ( medical , dental, vision) + Basic term and optional term life insurance + Short-term and ... long-term disability + Pregnancy disability and parental leave + 401(k) and employer-funded retirement plan + Paid vacation (from two to five weeks depending on salary grade and tenure) + Up to 11 paid holiday opportunities + Adoption assistance + Sick and… more
- State of Colorado (Denver, CO)
- Special Prosecutions Investigator (Special Agent III) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5001556) Apply Special Prosecutions ... Investigator (Special Agent III) Salary $98,328.00 - $118,008.00 Annually...position will investigate matters involving drug-related crimes, election crimes, fraud , homicide, human trafficking, identity theft, public corruption related… more
- CareFirst (Baltimore, MD)
- …**Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) + Certified Expert Coder-AHIMA or ... anti- fraud software analysis, and appropriately sourced reference materials. Investigator ensures timely maintenance and organization of case file documentation… more
- Molina Healthcare (St. Petersburg, FL)
- …ASSOCIATION** : + Health Care Anti- Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all ... **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation,… more
- Allied Universal (Augusta, GA)
- …+ One or more of the following professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... a difference. Enjoy comprehensive benefits for most full-time positions, including medical , dental, and vision coverage, life insurance, retirement plans, employee… more
- Allied Universal (Billings, MT)
- …+ One or more of the following professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator ... a difference. Enjoy comprehensive benefits for most full-time positions, including medical , dental, and vision coverage, life insurance, retirement plans, employee… more
- Office of Inspector General (Lombard, IL)
- Summary This office works within DOT to detect and prevent waste, fraud and abuse in departmental programs. The OIG reports to the Secretary and Congress and carries ... for planning, directing and conducting complex investigations of suspected fraud , waste, and abuse, and mismanagement in programs of...have in the past worked as a GS-1811 Criminal Investigator in a federal OIG office must clearly demonstrate… more
- State of Nevada (NV)
- AG CRIMINAL INVESTIGATOR 2 APPROXIMATE ANNUAL SALARY - $83,666.16 to $125,760.24 PAY GRADE: 41 The salary range indicated in this announcement is based on the ... area which includes, but is not limited to, Medicaid fraud , workers' compensation fraud , consumer protection, public...OR one year of experience as an AG Criminal Investigator I or Criminal Investigator I in… more
- Robert Half Legal (San Francisco, CA)
- Description We are on the lookout for an experienced Investigator - Securities, for our team located in San Francisco, California. This role will be focusing ... primarily on fraud investigation within the securities industry. You will be...effectively conduct investigations * Work closely with our current investigator to ensure comprehensive coverage * Apply your expertise… more
- MyFlorida (Lakeland, FL)
- …OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY CLASS TITLE: LAW ENFORCEMENT INVESTIGATOR II (SWORN INSURANCE FRAUD DETECTIVE) DIVISION: ... LAW ENFORCEMENT INVESTIGATOR II - 43005154 Date: Jul 25, 2025...Flexible Spending Accounts, Health Savings Accounts + Tax deferred medical and childcare reimbursement accounts + State of Florida… more
- Three Saints Bay (Washington, DC)
- **Field Investigator (5026)** Location **Washington, DC** Job Code **5026** \# of Openings **1** Apply Now ... Federal Government Contractor industry leader, is seeking an **Field Investigator ** **POSITION OVERVIEW:** This position will provide adjudication contractor support… more
- CVS Health (Carson City, NV)
- …it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and ... prosecution of healthcare fraud and abuse, to recover lost funds, and to...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Louisiana Department of State Civil Service (LA)
- Investigator /Special Agent 1-4 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4951050) Apply Investigator /Special Agent 1-4 Salary ... Justice, Office of Attorney General Liz Murrill, is seeking applications for an Investigator /Special Agent 1-4. As part of a Career Progression Group, vacancies may… more