• Health Insurance Fraud Analyst II

    MyFlorida (Tallahassee, FL)
    …broad scope of data analytics to proactively identify qualified leads for potential fraud , waste, and abuse (FWA) investigations . The incumbent will be ... DSGI. Knowledge, Skills, and Abilities: * Experience in auditing, data analysis, or fraud detection. * Knowledge of claims processing and medical terminology. *… more
    MyFlorida (08/20/25)
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  • Clinical Fraud Investigator II - Registered…

    Elevance Health (Tampa, FL)
    …in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify ... **Clinical Fraud Investigator II - Registered Nurse and CPC...prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new… more
    Elevance Health (08/16/25)
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  • Law Enforcement Investigator II

    MyFlorida (Orlando, FL)
    …law enforcement experience, or five (5) years of work experience conducting healthcare fraud investigations . Note: All newly hired employees must obtain CJSTC ... Statutes. These matters include but are not limited to: fraud against the Medicaid Program, false claims ...work which may include performing all aspects of Medicaid fraud investigations . This work includes but is… more
    MyFlorida (08/27/25)
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  • Asset Protection Manager

    Staples (Orlando, FL)
    …and programs in Supply Chain locations related to inventory loss, theft, and fraud . + Ensure appropriate internal risk controls are in place through the application ... of programs including data analysis, audits, training, and investigations . + Manage the Asset Protection Associate teams responsible for front line security in FCs… more
    Staples (08/14/25)
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  • FEMA Disaster Management Accountant

    CDM Smith (Orlando, FL)
    …CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial ... data related to disaster-related claims , including property damage, business interruption, and other loss...other loss categories. The specialist will conduct thorough forensic investigations to identify discrepancies, detect potential fraud ,… more
    CDM Smith (08/01/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
    Elevance Health (08/19/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    …for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + Examines claims ... relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control. + Reviews and...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
    Elevance Health (08/13/25)
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  • Investigator Senior

    Elevance Health (Tampa, FL)
    …identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on ... fraudulent claims . **How you will make an impact:** + Claim...Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one… more
    Elevance Health (08/28/25)
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  • Investigator Senior

    Elevance Health (Tampa, FL)
    …identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on ... fraudulent claims . Health insurance experience required with understanding of health...Responsible for independently identifying and developing enterprise-wide specific healthcare investigations and initiatives that may impact more than one… more
    Elevance Health (08/13/25)
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