• Manager , Fraud and Waste

    Humana (Raleigh, NC)
    …a part of our caring community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of ... fraudulent and abusive practices. The Manager , Fraud and Waste works within specific...schedules and goals. **Where you Come In** The Special Investigations Unit Manager assists coordinating investigation with… more
    Humana (08/09/25)
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  • Client Services Manager - Large Complex…

    EFI Global (Raleigh, NC)
    …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 ... leader in engineering failure analysis, origin-and-cause investigations , environmental consulting, laboratory testing and specialty consulting. Our forensic… more
    EFI Global (08/08/25)
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  • FEMA Disaster Management Accountant

    CDM Smith (Raleigh, NC)
    …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 (Winston Salem, NC)
    …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 (08/08/25)
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  • Investigator II

    Elevance Health (Winston Salem, NC)
    …the identification, investigation and development of 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 identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company health… more
    Elevance Health (08/08/25)
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