• Health Insurance Fraud Analyst II

    MyFlorida (Tallahassee, FL)
    HEALTH INSURANCE FRAUD ANALYST II - 72004150 Date: Aug 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 859230 Agency: Management Services Working Title: HEALTH INSURANCE FRAUD ANALYST II - 72004150 Pay...data analytics to proactively identify qualified leads for potential fraud , waste, and abuse (FWA) investigations . The… more
    MyFlorida (08/20/25)
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  • Assistant Attorney General (Financial Fraud…

    State of Colorado (Denver, CO)
    …referrals, assist with investigation of allegations of both securities and insurance fraud , and ultimately make charging decisions. We would be excited ... attorney will work on a multi-disciplinary team to prosecute insurance and securities fraud throughout the state....investigators, and paralegals who are dedicated exclusively to the investigation and prosecution of fraud . The attorney… more
    State of Colorado (08/22/25)
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  • Fraud & Investigations , Clinical…

    MVP Health Care (Rochester, NY)
    …RN. + New York State Nursing license required (RN preferred). Experience in health insurance fraud investigations preferred. + Obtain CPC and/or COC ... a related field, and minimum of five years of insurance claims investigation experience; or five years...SIU personnel. + Keep abreast of Federal and State Anti- Fraud investigation and reporting requirements including HIPAA,… more
    MVP Health Care (08/26/25)
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  • Deputy Director of Investigative Support,…

    New York State Civil Service (New York, NY)
    …and support personnel, tasked with analyzing and assessing financial and insurance fraud referrals;* Manages an Assistant Chief Investigator supervising ... and trends to help set investigative direction and focus;* Manages financial and insurance fraud referral intake procedures for thoroughness and timeliness, and… more
    New York State Civil Service (07/15/25)
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  • Director Financial Investigations…

    Highmark Health (Pittsburgh, PA)
    …documentation requirements, state and federal criminal and civil law related to insurance fraud and advances in the post-payment utilization review process ... & Provider Review (FIPR) organization. The strategic plan focuses on the detection and investigation of fraud , waste and abuse (FWA) and recoupment of related… more
    Highmark Health (08/08/25)
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  • Investigator - Special Investigations Unit

    Allied Universal (Mcdonough, GA)
    …course + Minimum of five (5) years of demonstrated experience conducting complex insurance investigations or adjusting complex insurance claims + Proficient ... Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation ...+ Certified Fraud Investigator (CFE) + Certified Insurance Fraud Investigator (CIFI) + Fraud… more
    Allied Universal (08/17/25)
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  • Assistant Director of Field Operations,…

    New York State Civil Service (New York, NY)
    …Chief Investigators each leading a criminal investigative team in financial and insurance fraud investigations covering upstate and downstate regions;* ... for the position of Assistant Director of Field Operations in the Investigations and Intelligence Division, Insurance Frauds Bureau. This position will… more
    New York State Civil Service (07/15/25)
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  • Senior Investigator (Hybrid)

    CareFirst (Baltimore, MD)
    …statutes and criminal and civil law impacting insurance fraud /abuse investigations to preserve the integrity of the investigation and to report possible ... **QUALIFICATIONS:** **Education Level:** Bachelor's Degree **Licenses/Certifications Preferred:** + Certified Insurance Fraud Investigator (CIFI) + Certified Expert… more
    CareFirst (07/12/25)
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  • Financial Crime Investigator I

    MyFlorida (Miami, FL)
    …the division investigates a wide range of fraudulent and criminal acts including: + Insurance Fraud Investigations + Workers' Compensation Fraud ... Estimator Tool (https://compcalculator.myflorida.com/) OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY DIVISION: CRIMINAL INVESTIGATIONS DIVISION BUREAU: PUBLIC ASSISTANCE FRAUD CITY:… more
    MyFlorida (08/23/25)
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  • Desk Investigator - SIU (Hybrid)

    Donegal Insurance Group (Marietta, PA)
    …Minimum of 3 to 5 years of Insurance Fraud or Insurance related experience + Law enforcement investigation experience preferred + Experience conducting ... Company Overview Donegal Insurance Group is an insurance holding...training of Claim Department personnel in the areas of fraud detection and investigation Qualifications and Skills… more
    Donegal Insurance Group (08/17/25)
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