Claims Audit & Fraud Investigator
Qlarant
Qlarant in the United States seeks a Claims Auditor to ensure the integrity of claims processes. This role involves conducting audits, analyzing data, and implementing strategies to prevent fraud. The ideal candidate has a Bachelor's Degree and 2-4 years of experience, with a preference for those holding a Certified Fraud Examiner certification. The position emphasizes communication and attention to detail. #J-18808-Ljbffr Qlarant
Vacancy posted 20 hours ago
Similar jobs that could be interesting for youBased on the Claims Audit & Fraud Investigator in New York, NY vacancy
- ...experienced candidate to ensure integrity in claims processes. This role requires conducting thorough audits/investigations, analyzing data to assess claims validity, and... ...2-4 years of relevant experience. A Certified Fraud Examiner certification is preferred. This position...Claims
- ...seeking an individual to ensure the integrity and accuracy of claims processes in the United States, Kentucky. The candidate will conduct audits and investigations into customer claims, focusing on identifying fraud, waste, and discrepancies while adhering to industry...Claims
$66.33k - $145.86k
...individual contributor role supports complex investigations and contributes to organizational... ...position plays a key role in identifying fraud risks, supporting program integrity efforts... ...identifies providers submitting non-NSA claims to CIDRE. Prioritizes and manages cases...ClaimsHourly payFull timeTemporary workLocal area- ...Great American Insurance Group is seeking a Special Claims Investigator for their Special Investigation Unit. This fully remote role involves... ...have 3 to 6 years of experience in Criminal Investigation or Fraud Detection, along with a relevant Bachelor’s Degree. Great American...ClaimsRemote work
- ...Haul International, Inc. is seeking a dedicated professional to join their Special Investigation Unit. This role focuses on identifying, investigating, and prosecuting fraudulent claims directed against Repwest Insurance Company. You will be responsible for training personnel...ClaimsFull time
$26 - $30 per hour
...Overview Claims Investigator – Part Time Brooklyn, NY Uncover the Truth. Protect the Integrity. Advance Your Career. At CoventBridge Group, every... ..., SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval...ClaimsHourly payPart timeH1bH2bWork from homeWorldwideFlexible hoursNight shift- CVS Health in Pennsylvania is seeking a skilled professional to manage complex cases involving health care fraud. The candidate will investigate claims, collaborate with law enforcement, and ensure adherence to health care regulations. Interested individuals must hold...ClaimsFull timeWork at office
- ...professional to ensure the accuracy and integrity of claims processes in Idaho. The role involves conducting audits and investigations into customer claims, analyzing data, and... ...and 0-2 years of experience, with healthcare fraud experience preferred. This position offers a...Claims
- Centene Management Company LLC is seeking a skilled investigator to handle allegations of healthcare fraud and abuse in New York. In this role, you'll plan, organize, and execute claims investigations, utilizing your expertise in data mining and report creation. The ideal...ClaimsRemote jobFlexible hours
$70k - $105k
...the Role Family banking has a distinct fraud profile. Minor cardholders face... ...transaction monitoring, and suspicious activity investigation, reporting directly to the Head of... ...activity escalation and reporting; maintain audit-ready case records. OFAC screening review...H1bRemote workVisa sponsorshipWork visaFlexible hours- Field Claim Investigator RC Services is seeking experienced and motivated Field Claims Investigators to support insurance claim investigations throughout New York. This is a great opportunity for individuals who thrive in fieldwork, enjoy investigative analysis, and can...ClaimsContract workFlexible hoursAfternoon shift
- ...Employee Benefits Corporation is hiring for a Fraud Prevention Analyst. In this role, you’ll... ...products and operations. You’ll combine investigation, analytics, and risk management to... ...investigations, determine root cause, and document audit‑ready findings with clear...Work at officeRemote workFlexible hours
$56.2k - $101k
Position Purpose Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. Conduct investigations of potential...ClaimsWork at officeRemote workFlexible hours- AAMGA AssuranceAmerica Managing General Agency, LLC is looking for a Liability Adjuster I to manage initial claims contact and determine coverage and liability exposure. This role requires managing expenses, achieving efficient file handling goals, and continuous professional...Claims
- A regional insurance provider is seeking a Customer-Focused Casualty Field Claims Representative to join their remote claims team in Virginia. The successful candidate will investigate claims, comply with company procedures, and provide tailored support to members. Ideal...ClaimsRemote jobWork at office
- CoventBridge Group is looking for a part-time Claims Investigator based in Brooklyn, NY. In this role, you will conduct investigations, document findings, and generate client-ready reports. Ideal candidates have 3-5 years of experience in claims and strong report writing...ClaimsRemote jobPart timeWork from homeFlexible hours
- ...Marine and Builders Risk. Qualifications Preferred experience in commercial insurance, real estate, inspection, construction, claim, loss control, underwriting, and/or fire and safety experience is a plus, but all interested candidates are encouraged to...ClaimsFor contractorsWork at officeLocal areaWork from home
- ...Working remotely in Georgia, the full-time Claims Auditor will investigate claims liability, process claims accurately according to existing policies... ...and excess insurance policies for individual claims Audit submitted claim documents for accuracy and compliance, determining...ClaimsFull timeWork at officeRemote work
- MetroPlusHealth in New York seeks a Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit. The successful candidate will review medical records and claims, conduct audits, and collaborate with the team on suspected fraudulent...Claims
- Fraud Ops Analyst - Hybrid Location: Kuala Lumpur, Malaysia Job Type: Hybrid Job Req Id: 25897809 Job Overview The Fraud... ...(1-2 years) Knowledge and previous experience in the Investigation and Fraud claims process Experience in trend analysis and alerts in early...ClaimsTemporary workWork at office
- ...Managing General Agency, LLC is seeking a Special Investigations Unit (SIU) Desk Investigator to assist with investigating suspected insurance fraud. This role requires conducting Examinations Under Oath, reviewing claim documentation, and analyzing damage while...Claims
$21 - $24 per hour
...insurance carriers on denied, underpaid, or unresolved insurance claims. This position requires a comprehensive understanding of the... ...Employment type Contract Job function Job function Accounting/Auditing Industries Hospitals and Health Care, Public Health, and Health...ClaimsContract workRemote workMonday to Friday- ...Operations to ensure that cash pay invoicing, contracting, and insurance claims are accurate, timely, and reimbursed in full. The ideal... ...and revenue reports for leadership review. Assist with audits and ongoing billing process improvement initiatives. Support...Claims
- The Office-of-the-Comptroller is looking for a Claims Specialist to manage non-tort claims against the City. The position requires... ...baccalaureate degree and offers the opportunity to handle detailed investigations, analyze liability, and prepare settlement recommendations....ClaimsPermanent employmentWork at office
- Working remotely, the full-time Fraud Reporting Analyst will develop and program methods to analyze fraud-related data, generate insights... ...aligned with regulatory standards, ensuring data integrity and audit traceability Collaborate with cross-functional teams to...Full timeWork experience placementRemote work
- ...London and Amsterdam. We are the first line of defense against fraud and abuse on the Plaid platform. Our mission is to ensure... ...be responsible for responding to fraud and abuse events, investigating claims, and triaging incidents. We also partner with product and engineering...ClaimsWork experience placementLocal area
- Imprint is hiring a Quality Assurance Analyst to audit fraud operations and disputes. This role evaluates processes, ensures compliance with SOPs, and helps identify gaps to reduce risks. You will create reports and work with teams to implement corrective actions effectively...
- ...Auditors! The ISG difference is the caliber of our team. Are you interested in becoming part of our market-leading, insurance premium audit team? At ISG, you can expect to : Be challenged - We provide you with exciting, challenging, and diverse audit projects. Grow...
- The Commonwealth of Kentucky is seeking a candidate for a position requiring routine travel for on-site audits. Responsibilities include auditing payroll records for compliance with KY UI tax laws and performing various reporting duties. Applicants must have a Bachelor...Remote job
$45k - $65k
...professional with experience in medical billing and insurance claims who’s eager to contribute to a mission‑driven, fast‑growing healthcare... ...level Entry level Employment type Full‑time Job function Accounting/Auditing and Finance Industry Mental Health Care #J-18808-Ljbffr...ClaimsFull timeRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Audit & Fraud Investigator. Be the first to apply!
Related searches
- fraud investigator New York, NY
- bank fraud investigator New York, NY
- claims attorney New York, NY
- claims associate New York, NY
- claims counsel New York, NY
- claims reviewer New York, NY
- medical claims auditor New York, NY
- claims coordinator New York, NY
- vice president claims New York, NY
- fraud prevention manager New York, NY


