- State of Colorado (Denver, CO)
- …will review referrals, assist with investigation of allegations of both securities and insurance fraud , and ultimately make charging decisions. We would be ... This attorney will work on a multi-disciplinary team to prosecute insurance and securities fraud throughout the state. In this position, you will have the… more
- Sanford Health (Fargo, ND)
- …evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies. Respond to subpoenas ... insurance investigation/audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE)… more
- Zurich NA (Overland Park, KS)
- …and providing support to colleagues. Your responsibilities may include: + Assess insurance claims for potential fraud indicators and recommend cases for ... Bachelor Apprenticeship Program - Claims Fraud Investigation - Schaumburg (January 2026) 126569 Have...complete your education while launching a career in commercial insurance -with no tuition costs. Now accepting applications for the… more
- New York State Civil Service (New York, NY)
- …and support personnel, tasked with analyzing and assessing financial and insurance fraud referrals;* Manages an Assistant Chief Investigator supervising ... and trends to help set investigative direction and focus;* Manages financial and insurance fraud referral intake procedures for thoroughness and timeliness, and… more
- Travelers Insurance Company (Richardson, TX)
- … industry. + Understanding of medical terminology. + Industry certifications (Certified Insurance Fraud Investigator, Certified Fraud Examiner, Accredited ... Case Unit Investigative Analyst, you will proactively analyze data to determine fraud schemes, trends and conduct major case investigations. Your attention to detail… more
- Highmark Health (Pittsburgh, PA)
- …documentation requirements, state and federal criminal and civil law related to insurance fraud and advances in the post-payment utilization review process ... strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment of related...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more
- Allied Universal (Palm Coast, FL)
- …professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate ... The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud ...of Insurance policies and the components of fraud to determine If claims warrant reporting to the… more
- Allied Universal (Fargo, ND)
- …professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate ... investigations or adjusting complex claims + Working knowledge and understanding of anti- fraud laws, insurance regulations, and compliance rules and standards in… more
- New York State Civil Service (New York, NY)
- …and administrative personnel tasked with analyzing and assessing financial and insurance fraud referrals and providing intelligence support and analysis ... activities, including planning and assigning work;* Directs the financial and insurance fraud referral intake process under the general supervision of the Deputy… 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 ... Fraud Control Unit: The Louisiana Medicaid Fraud ...resolves disputes, administers and enforces fair housing laws, manages insurance liquidations, and enforces state laws related to tobacco… more
- Louisiana Department of State Civil Service (Breaux Bridge, LA)
- …local, state, and federal law enforcement agencies, and through public education. + Insurance Fraud / Auto Theft Unit (IFAT) (https://lsp.org/ifu/) The IFAT Unit ... of fraudulent insurance acts; and promoting awareness of insurance fraud throughout the state. Additionally, the Unit is responsible for investigating… more
- MyFlorida (Jacksonville, FL)
- …division investigates a wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation Fraud Investigations + ... EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: PUBLIC ASSISTANCE FRAUD CITY: JACKSONVILLE COUNTY: DUVAL * **ATTENTION CANDIDATES THIS… more
- NTT DATA North America (Boston, MA)
- …information about assigned reviews Qualifications: 1-3 year's related experience in health insurance fraud investigations, health insurance coding, provider ... supported by evidence collected in the investigation Assisting in the preparing fraud referrals to other SIU investigative staff, regulatory agencies, and law… more
- MyFlorida (West Palm Beach, FL)
- …EMPLOYMENT OPPORTUNITY CLASS TITLE: LAW ENFORCEMENT INVESTIGATOR II (SWORN INSURANCE FRAUD DETECTIVE) DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: ... INSURANCE FRAUD CITY: WEST PALM BEACH COUNTY: PALM BEACH The...of Financial Services. This advertisement is for aBureau of Insurance Frauddetective. Click here (https://www.myfloridacfo.com/division/cid/home) for additional information about… more
- State of Arkansas (Little Rock, AR)
- … DEPARTMENT Anticipated Starting Salary: $55,929.95 Position Summary The Criminal Insurance Fraud Investigator is responsible for monitoring criminal activity ... related to insurance fraud matters. This position is governed by state and federal laws and agency/institution policy. This position requires on-site employment… more
- State of Michigan (Lansing, MI)
- …to prosecute matters involving other types of financial crimes, including but not limited to insurance fraud , securities fraud , tax fraud , practicing as ... or support other state agencies through our fiscal, IT, and HR systems. Insurance Benefits:The State of Michigan offers health, mental health, dental, and vision … more
- Bon Secours Mercy Health (Cincinnati, OH)
- …cycle risk areas highlighted by the OIG, Medicare, State Medicaid, State Insurance Fraud ; Managed Care or Governmental Value-Based payment programs and/or ... of compliance internal monitors and audit protocols and the prevention of fraud , waste and abuse. + Develops compliance monitors and audit protocols specific… more
- Command Investigations (Tampa, FL)
- JOB PURPOSE Conduct covert field surveillance, emphasizing worker's compensation fraud and insurance fraud . DUTIES AND RESPONSIBILITIES + Conduct covert ... /CERTIFICATIONS REQUIREMENTS + Valid state-issued driver's license. + Current auto insurance - required liability limits reflecting 100/300/100 for Bodily injury per… more
- Insight Global (Stamford, CT)
- …Crimes Specialists (CFCS) Certification One year of experience in the banking, insurance , accounting, fraud , and/or AML/BSA industries One year of investigative ... will be going through high volumes of adverse media/article/news alerts and screening for fraud or any other kind of financial crime. We are a company committed to… more
- MVP Health Care (Rochester, NY)
- …+ New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + ... justice or a related field, and minimum of five years of insurance claims investigation experience; or five years of professional investigation experience with… more
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