• Investigator , Special Investigative Unit…

    Molina Healthcare (Kenosha, WI)
    **JOB DESCRIPTION** **Job Summary** The Special Investigation Unit (SIU) Investigator is responsible for supporting the prevention, detection, investigation, ... review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and analyzing information to draw conclusions on… more
    Molina Healthcare (09/22/25)
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  • Surveillance Investigator - Part Time

    Command Investigations (Milwaukee, WI)
    …excellence. What you'll get: + A dedicated position as a surveillance investigator . + A steppingstone into the realms of investigations, security, and law ... to Work Compensation/Fraud/Mobile and Stationary surveillance + Hold a valid Private Investigator license - where applicable. + Possession of a high school diploma… more
    Command Investigations (08/04/25)
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  • Surveillance Investigator

    Allied Universal (Racine, WI)
    …and eligibility. **Job Description:** 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. + **Must** **p** **ossess** **a valid driver's license with at least one year of driving experience** + **Company… more
    Allied Universal (10/31/25)
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  • Healthcare Fraud Investigator *Clinical

    Sanford Health (Marshfield, WI)
    …investigation/audit. - Master's Degree preferred - Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred - ... insurance investigation/audit. Master's Degree preferred Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred… more
    Sanford Health (09/10/25)
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  • Operations Center Investigator - 3rd Shift

    Kohl's (Menomonee Falls, WI)
    …Shift: 3rd Shift (8:30 PM - 6:30 AM) About the Role As Operations Center Investigator , you will be the primary contact for store and Loss Prevention teams regarding ... fraud activity and significant events. You support field loss prevention associates, develop cases with local law enforcement to resolve organized retail crime, answer incoming associate calls to assist with shoplifting apprehensions or significant events,… more
    Kohl's (10/31/25)
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  • Investigator

    Highmark Health (Madison, WI)
    …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
    Highmark Health (10/24/25)
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  • Investigator , Coding Special Investigative…

    Molina Healthcare (Milwaukee, WI)
    **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... providers. This position uses information from a tip, member benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely turn around. This position… more
    Molina Healthcare (10/22/25)
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  • Security Engineer Investigator , Insider…

    Meta (Madison, WI)
    …activities related to insider threats. **Required Skills:** Security Engineer Investigator , Insider Trust Responsibilities: 1. Perform analysis, and threat hunting ... from a variety of log sources (eg, individual host logs, network traffic logs) to identify potential insider threats 2. Create workflows and automations to streamline signal detection, threat hunts, and investigative processes 3. Collaborate with software and… more
    Meta (08/27/25)
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  • Senior Fraud and Waste Investigator

    Humana (Madison, WI)
    …+ Bachelor's Degree or equivalent years of relevant work experience in Fraud & Abuse Investigations required + At least 2 years of healthcare fraud investigations and ... **Become a part of our caring community and help us put health first** The Senior Fraud and Waste Professional (Program Integrity Lead) is responsible for overseeing the monitoring and enforcement of the Fraud, Waste, and Abuse (FWA) program. This role aims to… more
    Humana (11/01/25)
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  • Retail Crime Investigator

    SpartanNash (Madison, WI)
    …**Position Summary:** This role is responsible to monitor customer and associate activity in assigned store for potential theft and prevent loss of company asset; ... At SpartanNash, we deliver the ingredients for a better life through customer-focused innovation. We do this for our supply chain customers and US military commissaries, retail store guests and, most importantly, our Associates. In fact, we see a day when each… more
    SpartanNash (10/30/25)
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