Insurance Fraud Investigator Jobs

829 jobs

GENERAL SUMMARY Responsible for planning, organizing, coordinating, and conducting the activities of investigations.Reports to General Counsel. MINIMUM QUALIFICATIONS · Any combination equivalent to two (2) years of college level course work in the social science field or three (3) years of client-related work at a social service agency. · Significant experience in law enforcement or licensed ...

Job Description Summary Responsible for timely SAR filing. Initial point of contact for physical security, fraud investigations, surveillance systems, and security procedures. Serves in advisory role for Retail branches and Home Office staff on security issues. Job Details ESSENTIAL FUNCTIONS: • Investigates cases of potential fraud and misconduct. Assesses the known/developed facts to determin...

Job Description The Mortgage team guides both new and existing clients in purchasing and maintaining the home of their dreams. We build strong relationships with our mortgage clients based on responsible lending and borrowing practices. Over 1,200 Brokers are backed by our team of Underwriters, Mortgage Processors, Loan Closers, and Loan Officers. The Mortgage team works with risk partners to off...

MAJOR RESPONSIBILITIES: Conduct with assistance data mining and data analysis utilizing claims data to detect aberrancies and outliers in claims and develop trends and patterns for potential cases Develop with assistance audit rules, queries and reports to detect potential FWA activity. Analyze member records and claims data to ensure compliance with applicable regulations, contracts and policy ma...

The AmeriHealth Caritas team is growing in Florida! AmeriHealth Caritas are the nation’s leading provider of health care solutions for the underserved—a mission-driven organization that has helped people in need for 30 years. Our companies positively impact the lives of nearly 5 million individuals in 13 states. As we expand, AmeriHealth Caritas is seeking talented, passionate associates to join ...

Overview: Located in Charlestown, MA, the Commonwealth Medicine Center for Health Care Financing (CHCF) helps state agencies, our primary clients, identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs and capitalize on all possible revenue streams. At the same time, we identify opportunit...

Overview: Located in Charlestown, MA, the Commonwealth Medicine Center for Health Care Financing (CHCF) helps state agencies, our primary clients, identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs and capitalize on all possible revenue streams. At the same time, we identify opportunit...

"Do you enjoy analyzing data for patterns and trends? Do you possess strong analytical, communication, and problem solving skills with a focus on fraud and data analysis? If so, this is the position for you!" -Hiring Manager What does the CardAlert Service Team do within FICO? CardAlert Service identifies and reports counterfeit payment cards to issuers before the majority of them incur fraud lo...

Orbitz Worldwide is an ecommerce market leader in travel and online technology. We provide customers with the ability to book a wide array of travel products and services from suppliers worldwide, including air travel, hotels, vacation packages, car rentals, cruises, rail tickets, travel insurance and destination services such as ground transportation, event tickets and tours Global consumer brand...

Old National Bank was established in 1834. Today we are the largest financial services holding company headquartered in Indiana. We provide an array of services to our clients which include Retail Banking, Investments, Wealth Management and Insurance. At Old National we believe that by helping our associates balance work life with home life, we create a more productive workforce and a stronger com...

Orbitz Worldwide is an ecommerce market leader in travel and online technology. We provide customers with the ability to book a wide array of travel products and services from suppliers worldwide, including air travel, hotels, vacation packages, car rentals, cruises, rail tickets, travel insurance and destination services such as ground transportation, event tickets and tours Global consumer brand...

BASIC FUNCTION The Special Investigator/Premium Fraud is responsible for the detection and investigation of premium fraud. ESSENTIAL RESPONSIBILITIES AND PRINCIPAL ACCOUNTABILITIES Denotes "essential functions" in accordance with the guidelines of the Americans with Disabilities Act. The essential functions of this position include, but are not necessarily limited to, those specifically identif...

Description: Position Description: Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as yo...

Description: Do you have a background in investigations of healthcare FWA? Have strong leadership skills? Do you have a desire to work within a collaborative team culture, leveraging diverse strengths for the benefit of the team? Bring us your experience, your head for compliance and investigations, your strength with relationships and your eye for opportunity. In return we offer an unmatched pla...

SURVEILLANCE INVESTIGATOR Company: PHOTOFAX, INC. Location: Milwaukee Area Status: Full Time Employee Career Level: No Experience Necessary, Will Train Job Requirements: Recent College Graduates with Criminal Justice Degree or Military background required MUST BE ABLE TO TRAIN THREE WEEKS IN CHICAGOLAND AREA Strong work and personal ethics Honest, self-motivated and team-oriented Strong ...

*0732 Special Investigator SUMMARY: Investigates claims that involve suspicions of fraud or other suspected wrongdoing both internally and externally. ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned. Identifies fraudulent or criminal activity and those responsible for such activities including arson, automobile accident schemes, personal injury schemes,...

Description: Position Description: Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as you d...

EVINE Live (evine.com) is at the intersection of retail and entertainment – a position few can lay claim to. We engage and inspire shoppers via TV, online and mobile, reaching over 88 million US homes via cable and satellite. We are reinventing what it means to be a “home shopping network” into a multi-screen digital shopping experience. We’re transforming ourselves into a product discovery destin...

Description: Position Description: Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healt...

Director - Special Investigations Unit - Commercial Insurance-64092 Description Advance your Claims career at Liberty Mutual Insurance- A Fortune 100 Company! As the Director, Special Investigations Unit you will manage and will be directly responsible for the Anti-Fraud Program including individual performance within the unit. Maintains highest level of authority within the Special Investigati...