Senior Manager, Prepay Fraud & SIU Investigations (Remote)
$87.7k - $157.8kCentene Corporation
- Remote job
Centene Corporation is seeking a qualified candidate to manage strategic fraud, waste, and abuse activities in New York. Responsibilities include monitoring billing integrity and leading a team for pre-payment investigations. Ideal candidates should possess a bachelor’s degree and over four years of relevant experience in healthcare or business. The position offers a pay range of $87,700 - $157,800 annually and includes a comprehensive benefits package that promotes flexibility in work arrangements. #J-18808-Ljbffr Centene Corporation
- Centene Corporation is seeking an Investigator to develop, implement, and manage strategic activities against fraud, waste, and abuse. You will ensure compliance and oversee billing integrity while leading a team in investigations. This role requires a bachelor’s degree...Remote jobSeniorFraudFlexible hours
- ...a dedicated individual to lead strategic fraud, waste, and abuse initiatives within our health plans. In this role, you will manage a team, monitor processes for integrity,... ...knowledge of medical terminology and fraud investigation. Join us for competitive pay and a...Remote jobSeniorFraud
- ...Corporation in North Carolina is seeking a professional to manage strategic fraud, waste, and abuse activities. This role involves ensuring... ...with state and federal requirements while leading a team to investigate fraud referrals and preparing saving reports. The ideal...Remote jobSeniorFraudFlexible hours
- Centene Corporation is seeking a qualified individual to manage strategic fraud, waste, and abuse activities. This position requires knowledge... ...compliance, with strong experience in medical claims and investigations. Candidates should have a Bachelor's degree and at least 4...Remote jobSeniorFraudFlexible hours
$87.7k - $157.8k
...Purpose Develop, implement and manage strategic fraud, waste and abuse activities by... ...Lead a team responsible for investigating fraud, waste and abuse referrals for prepay investigations Develop educational... ...approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours$107.7k - $199.3k
...Purpose: Serves as a senior leader and subject... ...and developing managers to build a high-... ...compliance-focused investigative team. Provides enterprise... ...violations, fraud, waste, and abuse... ...enforcement leadership, SIU, FWA, audit, and/... ...to work with remote, hybrid, field or...Remote workSeniorFraudFull timeContract workPart timeWork at officeFlexible hours$93.77k - $179.24k
...military spouses. USAA roles may offer remote or hybrid flexibility for active-duty... ...Opportunity We are looking for a dedicated SIU Investigator Senior - Major Case Unit. Within defined... ...claims by investigating complex fraud investigations with significant financial...Remote workSeniorFraudH1bLocal areaRelocation package- Capital One is seeking an AML Senior Investigator I for the Special Investigations Unit. This role... ...should have at least 2 years of AML or fraud investigative experience. Preferred qualifications... ...ACAMS or CFE. This position supports remote work but requires candidates to be...Remote jobSeniorFraud
$77k - $97k
West Bend Mutual Insurance Company is hiring a Senior Investigator in Phoenix, Arizona, focusing on insurance fraud investigations. This role combines remote work with field service, requiring analytical expertise and significant experience in fraud investigation. The...Remote jobSeniorFraud- ...Corp. in California is seeking a qualified candidate to develop and manage fraud, waste, and abuse activities. Responsibilities include monitoring compliance and leading a team focused on investigations, along with preparing savings reports. The ideal candidate has a...SeniorFraudFlexible hours
- Root Insurance is looking for a SIU Field Investigator II to conduct field investigations related to insurance fraud. This role requires strong critical thinking and investigative... ...and provide detailed reports. Root supports remote work across the US, encouraging flexibility...Remote workSeniorFraud
- RGP (Resources Connection) is seeking SIU support in Los Angeles for urgent fraud, waste, and abuse investigations. This role is essential for ensuring compliance with regulations and claims integrity. The ideal candidate will have experience in SIU investigations, strong...SeniorFraud
$25 - $50 per hour
...office politics Strong management support Professional... ...Paid travel for field investigations when required Job Summary The SIU Investigator conducts field and remote investigations involving... ...compensability analysis, fraud indicators, and investigative...Remote workFraudHourly payPart timeWork at officeHome officeAfternoon shift$83k - $132.8k
...Summary: The Special Investigations Unit (SIU) Investigator Lead is the face... ...FWA and support ongoing fraud investigations. Utilizes a... ...partnership with state regulators in managing Medicaid and Medicare... ...for cost avoidance through prepayment review, provider education,...Remote workFraudHourly payWork experience placementLive inWork at office- CareSource is looking for an SIU Investigator Lead in Kentucky to act as a primary representative for regulatory bodies. Your role includes ensuring compliance, leading fraud investigations, and using data analytics to detect fraudulent activities. The ideal candidate will...SeniorFraud
- CareSource is seeking an SIU Investigator Lead based in Kentucky. This pivotal role involves overseeing fraud investigations and managing regulatory communications with state and federal agencies. The ideal candidate will need to possess at least 10 years of experience...Remote jobFraud
$51k - $80.07k
Healthfirst is looking for an Investigator within the Special Investigations Unit (SIU) to conduct complex investigations of alleged misconduct and fraud in a fully remote position. The ideal candidate must possess an Associate's degree in criminal justice or equivalent...Remote jobFraud- Kemper is seeking a SIU Investigator to conduct field and desk investigations of insurance claims in the Tampa area. This remote position will require the investigator to function independently, coordinating investigations with various agencies and maintaining documentation...Remote jobFraud
- A major insurance provider in California is seeking a SIU Field Investigator to join their team. In this role, you will conduct investigations into suspected fraud, interview witnesses, and utilize various tools to gather evidence. The ideal candidate should have experience...Remote jobFraud
- Centene Corp. is seeking a full-time SIU Investigator to work remotely in California. This role involves investigating healthcare fraud allegations, performing data mining, and analyzing claims to identify potential abuse. Applicants should possess a Bachelor’s degree...Remote jobFraudFull time
$30 - $35 per hour
VRC Investigations seeks experienced Part-Time SIU Investigators in Phoenix, Arizona to combat insurance fraud. Candidates will investigate various insurance lines, conduct interviews, and report findings effectively. The role offers a competitive hourly wage of $30 to...Remote jobFraudHourly payPart time- ...mitigation company is seeking a full-time experienced Insurance SIU / Claims Field Investigator in the San Francisco area. The role involves conducting investigations, interviews, and online research to identify fraud in insurance claims. Candidates must have a strong skill...Remote jobFraudFull time
- ...seeking skilled and experienced Field Investigators for a fully remote, as needed position. This role... ...investigating various insurance claims including fraud and liability, offering flexible... ...and Special Investigations Unit (SIU) assignments, ensuring adherence to instructions...Remote jobFraudFlexible hours
- Aspire General Insurance Company is looking for a Pre-SIU Adjuster to investigate automobile claims with potential fraud. This full-time role, structured as a career... ...and decision-making skills. The position offers a remote work option and various benefits including...Remote jobFraudFull time
$67k - $79k
...Consulting is seeking a Special Claims Investigator to detect and prevent fraudulent... ...for Great American Insurance Group's SIU. This fully remote position allows for up to 30% business... ...experience in Criminal Investigation or Fraud Detection. The salary ranges from $67,...Remote jobFraud$30 - $35 per hour
A leading investigative firm based in Nashville seeks experienced part-time SIU Investigators to join their team. The role involves investigating potential fraud in insurance claims, conducting interviews, and preparing investigative reports. Candidates should have 5-10...Remote jobFraudHourly payPart timeWork at office$77k - $97k
Senior Investigator - Special Investigations Unit Job Locations... ...Full-Time Remote/Hybrid Remote... ...Investigate suspected insurance fraud involving auto, property... ...internal stakeholders Manage external vendors... ...fraud investigation, SIU, claims investigation,...Remote workSeniorFraudFull timeTemporary workWork at officeLocal areaWork from homeFlexible hours$117.3k - $146.6k
Root Insurance is looking for a Senior Manager in the Major Case Investigative Unit to lead efforts against insurance fraud. In this role, you will manage a team dedicated to investigating complex provider fraud schemes. The ideal candidate should have over 5 years of experience...SeniorFraud- Old National Bank is seeking a BSA/AML Investigations Manager in Joliet, Illinois, to develop, implement, and maintain compliance programs related... ...possesses over 8 years of experience in banking and fraud investigations, with strong interpersonal skills and advanced...SeniorFraud
$77k - $97k
West Bend Insurance Company is seeking a Fraud Investigator to work remotely but may require occasional travel to Arizona for team activities. This role involves investigating suspected insurance fraud across various lines including auto and property. The ideal candidate...Remote jobSeniorFraud
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