- Los Angeles Metro (Los Angeles, CA)
- …as a result of investigative work Develops, implements, and presents Insurance Fraud Identification Training Program to Risk Management Claims Staff and ... investigations, fraud investigations, law enforcement, internal investigations, insurance fraud , risk management claims , or other similar investigations;… more
- Koalafi (Richmond, VA)
- …patterns and proposing solutions or process changes to address them. Manage inbound fraud claims with professionalism and empathy, balancing customer care and ... financing experience and joining our team? What You'll Do: Fraud is a fast-evolving challenge in the financial industry-identity...protecting the integrity of our platform. As a Risk Investigator , you'll be at the heart of that… more
- FSA Federal (New York, NY)
- …use to generate subpoenas, engage with potential defendants, and determine whether to pursue claims . The investigator will also lend support to our existing ... of law enforcement and homeland security. We currently have a vacancy for a Civil Investigator . In this role, you will be supporting the overall mission of the US… more
- EFI Global, Inc. (Detroit, MI)
- …commercial buildings or residences. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Investigates assigned claims suspected of insurance fraud , this includes large loss, ... grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony,...large fire loss, and multiple claims . Ensures that assigned cases are investigated and reported… more
- EFI Global, Inc. (Phoenix, AZ)
- …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 ... and RESPONSIBILITIES Accepts assignments from customers for investigation of losses or claims and pursues investigation in accordance with the specific needs of the… more
- Kemper Corporation (Lake Mary, FL)
- … Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are ... Degree or equivalent work experience *Three years of insurance claims experience or related fraud analytics background....NICB Basic and/or Analytics Academies are desirable. Certified Insurance Fraud Analyst (CIFA), Fraud Claims … more
- Otsuka Pharmaceutical Co., Ltd. (Princeton, NJ)
- …of clinical facility and system audits at all relevant facilities, investigator sites, and vendors (including contract research organizations) and ensure that ... accommodations by contacting Accommodation Request. Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security and protection...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- City of New York (New York, NY)
- …stipulated in their agreement to repay. Claims &Collection is recruiting for (4) four Fraud Investigator II to function as a Senior Fraud Investigator ... Job Description Claims and Collections pursues monetary recoveries owed to...discuss their cases and obtain additional information (if necessary) FRAUD INVESTIGATOR - 31113 Qualifications 1. A… 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 ... employment, unless an accommodation is granted as required by law. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities… more
- Elevance Health (Gilbert, MN)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Allied Universal (Billings, MT)
- …**required** **prior to applying** Allied Universal(R) is hiring a Surveillance / Claims Investigator . Surveillance / Claims Investigators validate the ... + One or more of the following professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator… more
- Allied Universal (Las Vegas, NV)
- …as needed to ensure a full schedule** Allied Universal(R) is hiring a SIU / Claims Investigator . SIU / Claims Specialists investigate claims with ... extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting...more of the following professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance … 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
- Command Investigations (FL)
- …hire. Visit our website and find out why at www.GoCommand.com . The Claims /Surveillance Investigator should demonstrate proficiency in the following areas: + ... setting the bar high for investigative excellence. Seeking experienced Insurance Fraud Investigators with commercial or personal lines experience, with multi-lines… 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
- State of Arkansas (Little Rock, AR)
- …audit, or a similar investigative role. Specialized certifications (eg, Certified Fraud Examiner, Certified Forensic Investigator ) may be required. PREFERRED ... *Presenting evidence * Interviewing witnesses Job Summary: Review Incident and Accident claims as assigned by the lead investigator Perform a thorough… 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
- State of Georgia (Fulton County, GA)
- …Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator - Medicaid Fraud Division *To move forward in the recruiting process ... Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot...will serve within the Audits section of the Medicaid Fraud Division. Job Summary Under the direction of the… more
- Command Investigations (Detroit, MI)
- …Candidates may have an advantage where they possess: MACP experience A djuster/PIP claims experience Prior experience as a private investigator Prior law ... experienced candidates to join our special investigations unit as an ACP Investigator . SuperiorX Investigations is the premier servicer for insurers and defense… more
- City of New York (New York, NY)
- …exceed the allowable levels. Claims and Collections (C&C) is recruiting (1) one Fraud Investigator II to function as a Senior Investigator , who will: ... Job Description APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE The...of Revenue that houses DSS Accountability Office (DSS-AO) (C&C). Claims and Collections (C&C) collects cash assistance overpayments from… more
