Fraud Claims Investigator Jobs

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ORGANIZATION OVERVIEW: Commonwealth Care Alliance is a rapidly growing nonprofit organization providing integrated healthcare and social support services to people with complex medical needs. Our patients are seniors and persons with disabilities covered under Medicaid or both Medicaid and Medicare. Our innovative care model is nationally recognized for its effectiveness in improving health outco...
Description Ernst & Young's Government Contract Services (GCS) is one of the diverse offerings of our Fraud Investigation and Dispute Services (FIDS) practice. For over 25 years GCS has helped companies deal with the significant challenges and requirements that are inherent with doing business with the government. GCS professionals help clients navigate through the strict rules and regulations of...
Blue Shield of California El Dorado Hills, CA, 95762
Our Company Blue Shield of California (BSC) has been a leading non-profit provider of quality health insurance plans for over 70 years. Its mission is to ensure that all Californians have access to high-quality health care at an affordable price. Founded with the name of California Physicians' Service (CPS) in 1939, it now has annual revenue of -$12 billion, 3.5 million members, 5,000 employees, ...
Deutsche Bank New York, NY, 10007
A Passion to Perform. It’s what drives us. More than a claim, this describes the way we do business. We’re committed to being the best financial services provider in the world, balancing passion with precision to deliver superior solutions for our clients. This is made possible by our people: agile minds, able to see beyond the obvious and act effectively in an ever-changing global business landsc...
Education: - Qualified candidates must have a high school degree or GED Experience: - Prior front office medical experience, medical case management, and/or medical social work experience a plus Skills: - Must possess professional writiting skills and ability to correspond with professionals both verbally and in writing. - Strong verbal communications, problem solving, time management and organiza...
University of California Berkeley Berkeley, CA, 94705
About Berkeley The University of California, Berkeley, is one of the world’s most iconic teaching and research institutions. Since 1868, Berkeley has fueled a perpetual renaissance, generating unparalleled intellectual, economic and social value in California, the United States and the world. Berkeley’s culture of openness, freedom and acceptance—academic and artistic, political and cultural—make...
Verisk Analytics Jersey City, NJ, 07097
Are you a recent grad looking to work in a fast paced publicly traded company? If you have exceptional client interfacing skills and technical skills, and enjoy working in a highly collaborative environment, please read on… Verisk’s ClaimSearch team is seeking an innovative and self-starting Business Analyst, like you, to assist clients with CMS Medicare regulatory reporting. The legislation requ...
ISO Insurance Services Jersey City, NJ, 07097
Company Name: Verisk Claims & Crime Analytics Description: Are you a recent grad looking to work in a fast paced publicly traded company? If you have exceptional client interfacing skills and technical skills, and enjoy working in a highly collaborative environment, please read on… Verisk’s ClaimSearch team is seeking an innovative and self-starting Business Analyst, like you, to assist clients...
Business Analyst- Operations Analytics Have you ever thought about what it takes to detect and prevent fraudulent purchases among hundreds of millions of eCommerce transactions in six countries? What would you do to create a trusted marketplace where millions of buyers and sellers can safely transact online? What kinds of processes and systems would you build to maximize customer satisfaction? O...
Texas Health & Human Services Commission Austin, TX, 78719
Actuary II Works under general supervision with moderate latitude for the use of initiative and independent judgment. Performs highly complex actuarial analysis of health claims data in order to determine error rates in claims paid and encounters. -Constructs actuarial/probability tables for state and federal Medicaid programs, including but not limited to Medicaid Program Integrity, Utilization...
NCR Corporation Duluth, GA, 30198
Qualifications/Educational Requirements: Bachelor degree required CPP or CFE certifications preferred. Minimum of 12 years relevant functional experience required, preferably in corporate security and governmental investigative or enforcement agencies. At least five years should be in a leadership role with ownership for strategy and leading the organization. Complete knowledge and understandi...

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Business Career Tools

Claims Investigator - Fraud

Salaries

$27,040.00 - $89,670.00
Typical Salary for Claims Investigator - Fraud
(88 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
56.9%
Some College Coursework Completed
13.8%
Master's
13.8%
Associates
8.6%
High School
6.9%
(58 Respondents)
Source: Monster.com Careerbenchmarking Tool

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