- Zelis (Boston, MA)
- …and the personal interests that shape who you are. Position Overview The Fraud Investigation Analyst, Enterprise Fraud , will contribute significantly to ... fraudulent activities by conducting comprehensive reviews of all internal and external fraud monitoring alerts, performing fraud investigations , and… more
- Molina Healthcare (Louisville, KY)
- … Services , Member Services , Claims) to gather documentation pertinent to investigations . + Detects potential health care fraud , waste, and abuse through ... opinions. + Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations . + Knowledge of Managed Care and the Medicaid and… more
- Allied Universal (Provo, UT)
- …Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services . Allied Universal(R) Compliance and Investigation ... demonstrated professional law enforcement experience with specific attention to investigations related to fraud + Ability to...+ Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate (FCLA) + … more
- Humana (Tallahassee, FL)
- …& Abuse Investigations required + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment methodologies ... community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of...requires an in-depth evaluation of variable factors. The Senior Fraud and Waste Professional coordinates investigation with… more
- Allied Universal (Fargo, ND)
- …Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services . Allied Universal(R) Compliance and Investigation ... the premier destination for a career in insurance claim investigation . As a global leader, we provide dynamic opportunities...+ Certified Insurance Fraud Investigator (CIFI) + Fraud Claim Law Associate (FCLA) + … more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible ... with all statutory, regulatory, and contractual standards. Bureau of Fraud Investigation (BFI) is mandated to detect...Legal Affairs (OLA). BFI/ID is recruiting for (2) two Associate Fraud Investigators II to function as… more
- Capital One (St. Cloud, MN)
- Work From Home - Senior Complaints Coordinator - FDO Escalations - Fraud Account Management Investigations Solutions (FAMISE) **Are you looking for a challenging ... must be provided by Cable or Fiber Internet Service Providers (ISP) + Hotspots and satellite services...right to request proof of internet provider, speed and service package from the associate . Requirements are… more
- Humana (Denver, CO)
- …our caring community and help us put health first** The Manager, Fraud and Waste Investigator: Nurse Audit/Review performs clinical audit/validation processes to ... ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …the following: Required * Experience: Proven, progressive experience in insurance investigations , regulatory compliance, financial crimes investigation , or a ... Number 26-01244 Agency 216 Department of Insurance & Financial Services - Insurance Opening Date 11/10/2025 Closing Date 11/30/2025...(eg, Certified Insurance Fraud Investigator (CIFI), * Fraud Claim Law Associate (FCLA), Senior Claim… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible ... for protecting the integrity of social services programs administered by the New York City Department...the allowable levels. C&C is recruiting for (1) one Associate Fraud Investigator II to function as… more
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