- Bank OZK (Clearwater, FL)
- …instances described within the Bank's Fraud Risk Management Program. + Performs fraud investigations derived from escalated fraud alerts and other ... as branch personnel or law enforcement. + Conducts moderately complex fraud investigations and link analysis that may include multiple subjects, incidents, and… more
- Molina Healthcare (Miami, FL)
- …opinions. + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations . + Knowledge of Managed Care and the Medicaid and ... Healthcare Services, Member Services, Claims) to gather documentation pertinent to investigations . + Detects potential health care fraud , waste, and… more
- Bank OZK (Apollo Beach, FL)
- …described within the Bank's Fraud Risk Management Program. + Performs complex fraud investigations derived from escalated fraud alerts and other various ... such as branch personnel or law enforcement. + Conducts complex fraud investigations and link analysis that may include multiple subjects, incidents, and… more
- Zelis (St. Petersburg, FL)
- …for payment transaction, ACH enrollment, and provider verification. + Oversee fraud investigations , root cause analyses, and escalations, ensuring timely ... PINS). As the Fraud Manager, you will be responsible for overseeing fraud detection strategies, leading complex investigations , and enhancing fraud … more
- Bank OZK (Tampa, FL)
- …teams, and leverages the intelligence from those sources to conduct effective cyber fraud investigations . + Builds internal relationships with cyber, fraud , ... Purpose & Scope Performs complex cyber financial crime data-driven investigations and analytics in support of cyber fraud... investigations and analytics in support of cyber fraud incident management. Essential Job Functions + Provides key… more
- MyFlorida (Miami, FL)
- …investigates a wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation Fraud Investigations ... Estimator Tool (https://compcalculator.myflorida.com/) OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: PUBLIC ASSISTANCE FRAUD CITY:… more
- Prime Therapeutics (Tallahassee, FL)
- …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations /claims experience. + Ability to manage workload while… more
- Bank OZK (Tampa, FL)
- … schemes, ability to identify red flags and suspicious activity, and conduct fraud investigations , when necessary. + Knowledge of applicable regulations and ... the independent testing standards for AML. + Actively identify and assess fraud risks by reviewing internal controls, operating processes, analyzing data for… more
- MyFlorida (Miami, FL)
- …or West Palm Beach, Florida, and involves auditing complex multi-million-dollar healthcare fraud investigations that can result in criminal and/or civil ... as lead investigator on cases involving suspected Cost Report Fraud and Prospective Payment System Medicaid provider fraud... Fraud and Prospective Payment System Medicaid provider fraud involving: 1) Nursing Homes, 2) Hospitals, and 3)… more
- CVS Health (Tallahassee, FL)
- …Medicaid experience is preferred. Leads a team in the planning and execution of investigations of acts of healthcare fraud and abuse by both members and ... **Required Qualifications** + 2 to 5 years of managing healthcare fraud , waste and abuse investigations and audits. + 3 to 5 years of leadership experience… more