- Capital One (Wilmington, DE)
- AML Investigator , Transaction Monitoring Operations The qualified candidate will support various Anti-Money Laundering (AML) processes for our various lines of ... occasional tasks independently + Typically reports to: AML Supervisor (Sr. Investigator ) **Basic Qualifications:** + High school diploma, GED, or equivalent… more
- Elevance Health (Wilmington, DE)
- ** Investigator Assistant** **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 Assistant** is responsible for providing administrative support to the… more
- TD Bank (Wilmington, DE)
- …Risk Management **Job Description:** The Financial Crime Risk Lead Investigator leads thematic (ie, regulatory/public private partnerships) investigative projects, ... on the investigative output of the teams. The Financial Crime Risk Lead Investigator conducts end to end investigations of various higher complexity and sensitivity… more
- Allied Universal (Wilmington, DE)
- …**to!** + **Guaranteed Time Off** Allied Universal(R) is hiring a Surveillance Investigator . The Surveillance Investigator will perform discreet mobile and ... stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an Insurance claim. **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types,… more
- Elevance Health (Wilmington, DE)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Fraud Investigator II** is responsible for identifying issues and/or entities that… more
- Elevance Health (Wilmington, DE)
- ** Investigator Senior** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually full-time, with the exception ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Investigator Senior** is responsible for the independent identification, investigation… more
- CVS Health (Dover, DE)
- …it all with heart, each and every day. The SIU Senior Investigator conducts complex investigations to effectively pursue the prevention, investigation and ... prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with state regulations mandating fraud plans and practices. **What you will do** - Routinely handles complex cases involving behavioral health or multi-disciplinary provider groups… more
- TD Bank (Wilmington, DE)
- …Management **Job Description:** **Department Overview:** As a Financial Crime Risk Investigator II, you will conduct investigations of moderate complexity for both ... internal and external cases regarding money laundering and terrorist financing. You will make recommendations for demarketing and/or freezing accounts by the appropriate investigative unit. You will also conducts adjudications of moderate complexity and… more
- City National Bank (Wilmington, DE)
- *FINANCIAL CRIMES INVESTIGATOR SENIOR* WHAT IS THE OPPORTUNITY? Responsible for performing analysis on clients' transactions identified through the bank's anti-money ... laundering (AML) system to ensure compliance with BSA and USA Patriot Act. WHAT WILL YOU DO? * Perform analysis on clients' transactions identified through the monitoring system that involves various transaction types including but not limited to cash, wire… more
- Highmark Health (Dover, DE)
- …Coder (CPC) + Certified Outpatient Coder (COC) + Accredited Healthcare Fraud Investigator (AHFI) **SKILLS** + Must have knowledge of provider facility payment ... methodology, claims processing systems and coding and billing proficiency + Must have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining… more
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