- Allied Universal (Batavia, NY)
- …professional industry certifications: + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law ... an Insurance claim. The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant… more
- Allied Universal (Buffalo, NY)
- …professional industry certifications + Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law ... investigations or adjusting complex claims + Working knowledge and understanding of anti- fraud laws, insurance regulations, and compliance rules and standards in… more
- MVP Health Care (Schenectady, NY)
- …+ New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC credential. + ... agencies, or seven years of professional investigation experience involving economic or insurance related matters. + A clinical investigator must have in… more
- Guardian Life (New York, NY)
- …+ Ability to spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and manual exception reports and ... but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business...million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to… more
- Highmark Health (Albany, NY)
- …Professional Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider ... **Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + 1 year… 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 ... day-to-day activities, including planning and assigning work;* Directs the financial and insurance fraud referral intake process under the general supervision of… more
- New York State Civil Service (New York, NY)
- …diverse fraud schemes and other emerging criminal activity affecting insurance , financial and healthcare companies;* Monitors investigator performance to ... oversee and manage approximately eight to ten investigators assigned to investigate insurance , financial and healthcare fraud across upstate and downstate… more
- New York State Civil Service (Albany, NY)
- …experience in conducting financial fraud investigations to include no -fault insurance fraud ; an understanding of law enforcement agencies throughout the ... NY HELP No Agency Financial Services, Department of Title Investigator , NS Occupational Category Other Professional Careers Salary Grade NS Bargaining Unit PS&T -… more
- Elevance Health (Latham, NY)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per week, ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- New York State Civil Service (New York, NY)
- …Chief Investigator within the Department's Investigations and Intelligence Division, Insurance Frauds Bureau. The position will report directly to the Deputy ... HELP No Agency Financial Services, Department of Title Assistant Chief Investigator - Support Operations, NS Occupational Category Other Professional Careers Salary… more