- Ally (Raleigh, NC)
- …-related challenges. **The Skills You Bring** * 7 years of experience in card fraud management required. * Expert knowledge of card authorization with a focus ... your opportunities be, too? **The Opportunity** The Debit Card Fraud Program Leader is responsible for driving the strategy...Reg E and Mastercard's dispute rules to support accurate claims management and loss recovery. * Strong… more
- Humana (Raleigh, NC)
- …investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced ... Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of...Medicare experience + Minimum 3 years of experience with Fraud , Waste, and Abuse in a Managed Care setting… more
- Zurich NA (Raleigh, NC)
- Marine Claims Specialist II 126114 Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and Liability experience ... With moderate direction, handles single and multi-party commercial Marine and Liability claims of low to moderate exposure and complexity within specific limits of… more
- Sedgwick (Raleigh, NC)
- …as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience ... claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best… more
- CVS Health (Raleigh, NC)
- …thoroughness and accuracy of investigations aimed at preventing payment of fraudulent claims by insured individuals, providers, claimants, etc. + Analyze and prepare ... the required timeframe. + Support the recovery of company funds lost due to fraud by providing insights and recommendations based on case reviews. + Collaborate with… more
- Wells Fargo (Charlotte, NC)
- …ensure the seamless execution, compliance, and innovation of payment processes across our global network. ** Fraud and Claims Management :** + Fraud and ... high-risk transactions to prevent victim and perpetrator fraud , processes check fraud and Automated Clearing House (ACH) claims , investigates and resolves… more
- Prime Therapeutics (Raleigh, NC)
- …& Experience** + Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the ... for work visa or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations/ claims experience. + Ability to manage workload while… more
- Travelers Insurance Company (Charlotte, NC)
- …improve the claim results of others. + Applies the Company's claim quality management protocols and Best Practices to all claims ; documents the rationale for ... as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. + Verifies the nature...adherence to quality standards. + Utilizes diary management system to ensure that all claims … more
- Travelers Insurance Company (Charlotte, NC)
- …Claim File Analysis (CFA) by adhering to quality standards. + Utilizes diary management system to ensure that all claims are handled timely. At required time ... and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle… more
- Sedgwick (Raleigh, NC)
- …various specialized services such as subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective ... PURPOSE** **:** To manage claim caseload of basic to highly complex claims within granted authority level including related financial implications, along with… more