• Senior Fraud Investigator

    Guardian Life (Holmdel, NJ)
    …financial services fraud investigations + Series 7 and CAMS and/or CFE designation strongly preferred (or willingness to obtain certification within 18 months of ... spot trends, red flags, suspicions of money laundering and fraud through the review of automated alert scenarios and...but not limited to Suspicious Activity Reports and state fraud reporting. + Provides subject matter expertise to business… more
    Guardian Life (06/06/25)
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  • Fraud Recovery Investigations Associate

    Guidehouse (Richardson, TX)
    …None **What You Will Do** **:** + Conduct quality assurance reviews of fraud recovery cases handled by analysts to ensure accuracy, completeness, and adherence to ... identify and analyze points of compromise, and communicate potential risk to Fraud leadership. + Determine action required based on established procedures and work… more
    Guidehouse (06/08/25)
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  • Fraud Recovery Investigations Analyst

    Guidehouse (Richardson, TX)
    …employment with our rapidly growing firm. Guidehouse is seeking experienced Fraud Recovery Investigations Analyst's to conduct, identify, and investigate potential ... fraud recovery cases. The role involves working closely with...drafting and filing Suspicious Activity Reports (SARs) + CAMS, CFE certification **What We Offer** **:** Guidehouse offers a… more
    Guidehouse (05/17/25)
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  • Fraud Recovery Investigations - Associate…

    Guidehouse (Richardson, TX)
    …Required** **:** None **What You Will Do** **:** + Manage the Fraud Recovery function, including personnel management, queue management, quality assurance, and ... and efficient processing of cases. + Conduct quality assurance reviews of fraud recovery cases to ensure accuracy, completeness, and adherence to established… more
    Guidehouse (06/01/25)
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  • Fraud and Waste Investigator

    Humana (Tallahassee, FL)
    …part of our caring community and help us put health first** The Fraud and Waste Professional 2 is responsible for conducting comprehensive investigations of ... reported, alleged or suspected fraud involving Florida's Medicaid Program. The Fraud ...and/or certifications (MBA, JD, MSN, Clinical Certifications, CPC, CCS, CFE , AHFI). * Understanding of healthcare industry, claims processing… more
    Humana (06/06/25)
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  • Fraud and Waste Investigator

    Humana (Baton Rouge, LA)
    …and help us put health first** Humana's Special Investigations Unit is seeking a Fraud and Waste Investigator to join the Louisiana Medicaid Team. This team of ... Investigators conducts investigations into allegations of fraud , waste, and abuse involving providers who submit claims to Humana's Louisiana Medicaid line of… more
    Humana (06/04/25)
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  • Fraud Recovery Investigations Team Lead

    Guidehouse (Richardson, TX)
    …Will Do** **:** + Oversee the daily operations of a team of 10+ Fraud Recovery Analysts, ensuring that all team members are meeting performance and productivity ... goals. + Conduct quality assurance reviews of fraud recovery cases handled by analysts to ensure accuracy,...drafting and filing Suspicious Activity Reports (SARs) + CAMS, CFE certification **What We Offer** **:** Guidehouse offers a… more
    Guidehouse (05/23/25)
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  • Investigator

    Highmark Health (Tallahassee, FL)
    …Contracting **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner ( CFE ) + Certified ... Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment… more
    Highmark Health (05/08/25)
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  • Director Complex Claims

    Sedgwick (Fort Worth, TX)
    …Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), or Certified Fraud Examiner ( CFE ) strong preferred, or equivalent ... achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in… more
    Sedgwick (05/08/25)
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  • Senior Auditor - Financial Crimes…

    Regions Bank (Birmingham, AL)
    …and Investment Risk Specialist (CFIRS) + Certified Financial Systems Auditor (CFSA) + Certified Fraud Examiner ( CFE ) + Certified Information ... certification or progression towards one, preferably one of the following: + Certified Anti-Money Laundering Specialist (CAMS) + Certified Bank Auditor (CBA)… more
    Regions Bank (05/13/25)
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