Fraud Investigator
Highmark Health
Highmark Inc. is seeking a senior anti-fraud professional to develop and sustain an enterprise fraud program. You will lead investigations into fraud, waste and abuse across providers, members, facilities and staff, and coordinate with federal, state and local authorities. The role requires presenting findings, testifying where needed, and guiding audits for regulatory compliance. You will train teams, mentor investigators, and drive annual fraud plans while staying current with insurance laws #J-18808-Ljbffr
$100k - $135k
...and accurately share knowledge with their teammates.ABOUT THE ROLE:We are seeking a Fraud Analyst to join our BSA/AML team. In this role, you will support the detection, investigation, and mitigation of financial crime risks, with a strong emphasis on fraud-related activity...SuggestedPermanent employmentFull timeTemporary workWork at officeRemote workWeekend work$70.9k - $93k
...professional who is comfortable operating at the intersection of fraud risk, anti-money laundering, and financial crime. You are... ...also a critical thinker who looks beyond individual alerts and investigations to identify patterns, emerging risks, and opportunities to strengthen...Suggested- ...way. Join us to invest in yourself, your career, and the financial world. The role We are searching for a passionate Staff Fraud Risk Analyst who is highly self-motivated, analytical, with a decent understanding of debit card fraud transactions and account...SuggestedWork experience placementRemote work
$70k - $85k
...We are currently seeking an entry-level Staff candidate with up to two years of public accounting experience to work within our Investigative Accounting Group. We offer a flexible, hybrid work environment. The majority of our engagements involve working with commercial...SuggestedWork experience placementLocal areaFlexible hoursNight shift- Forensic Accountant / Business Interruption Specialist Location: New York A leading global forensic accounting firm is seeking an experienced Forensic Accountant / Business Interruption Specialist to join its New York office. This is an excellent opportunity to work on...Suggested
- ...able to work independently You will have advanced data mining experience You will have an Analytical mindset and love to crunch data Fraud background preferred (data driven/data analytics/AI) Excellent communication skills both verbally and written What you will be doing...Full time
- Job Overview We’re hiring a Fraud Prevention Analyst to identify, analyze, and prevent fraudulent activity across customer accounts and transactions. You’ll monitor high‑risk patterns, investigate suspicious behavior, and help strengthen fraud controls. Responsibilities...
- ...MaziCTools is seeking candidates for a full-time role focused on fraud investigations and analytics. The position involves engaging with engineering teams and non-technical stakeholders to enhance workflows. Ideal candidates will have a Bachelor's degree in a technical...Full timeWeekend work
- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing claims data, and preparing reports. A bachelor's degree and 1+ years in medical claim analysis are essential. Preferred candidates...Remote work
$85k - $105k
...,000.00/yr - $105,000.00/yr Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions...Full timeWork experience placementWork at officeLocal area- ...explore ideas and impact the roadmap and vision of our company.The fraud risk management team at Rain creates sophisticated, scalable... ...and customers.Create ad hoc data pulls with SQL for anomaly investigation and analyze the results for fraudulent activity.Document...Work at officeWork from homeWorldwideWork visaFlexible hours
$171.12k
...See yourself at Twilio Join the team as Twilio’s next emerging Fraud Researcher. About the job This position is needed to detect... ...detection models and reduce false positives. Conduct in-depth investigations into high-impact fraud incidents, providing root cause analysis...For contractorsLocal areaRemote workWorldwide$85k - $110k
...currently seeking a career-minded Senior Forensic Accountant with two to five years of public accounting experience to work within our Investigative Accounting Group. We offer a flexible, hybrid work environment The majority of our engagements involve working with...Work experience placementLocal areaFlexible hoursNight shift$66.96k
...Office of the New York State Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) seeks forensic accountants/auditors (FAA)... ...and legal support analysts to conduct complex healthcare fraud investigations. The Medicaid program provides health coverage to millions of...Work experience placementWork at officeLocal areaRemote workFlexible hours$90k - $142k
...Supervisor - Litigation will oversee forensic accounting and litigation support engagements, providing expertise in financial fraud investigations, damage calculations, and dispute resolution. The role involves working closely with attorneys, clients, and internal teams...Full time- ...are building the future, today. About the Role As our Senior Fraud Analyst for Consumer Lending , you will be the gatekeeper protecting... ...team to build, optimize, and scale automated block and manual investigation policies. Advanced Risk Tooling: Liaison with the central...Remote work
$40k - $49k
Fraud Investigator Job No: 543709 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Accounting/Auditing, Administrative Support/Customer Service, Research, Healthcare/Nursing/Investigations/Compliance AHCCCS Arizona Health Care Cost Containment System...Full timePart timeSelf employmentInternshipWork at officeRemote workFlexible hoursNight shift- Focused on protecting the integrity and profitability of financial products, the full-time remote Fraud Investigator II will execute fraud and risk operations, conduct investigations into suspicious activities, and develop scalable fraud controls across the customer lifecycle...Full timeRemote workShift work
$66.3k - $75.33k
Municipal Credit Union, based in New York, seeks a Fraud Analyst to prevent losses and support investigations within Financial Crimes & Intelligence. You will analyze alerts from fraud detection systems, assess risk, compile investigations, and ensure compliance with BSA...Remote job$26 - $33 per hour
...Job Type Full-time, Part-time Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of one year of experience to become part of a dynamic team. This is a great opportunity for individuals with prior claims...Hourly payFull timePart timeSecond jobWork at officeRemote workFlexible hoursNight shift- ...they feel valued, empowered and rewarded for all that they do. Why this role matters Fraud can have a lasting impact on a member's financial well-being and trust. As a Fraud Investigator II at Truliant Federal Credit Union, you'll lead complex investigations that help...Full timeTemporary workLocal areaFlexible hours
- Conducting comprehensive fraud, waste, and abuse (FWA) investigations, the full-time SIU Investigator will analyze claims data, medical records, and provider information while collaborating with internal and external stakeholders to support case resolution and ensure compliance...Full timeRemote work
- To shape fraud strategy as the company scales, the full-time Senior Fraud Analyst will manage fraud controls across payment products, identify emerging threats, and collaborate with cross-functional teams in a hybrid work environment. Key responsibilities Own and evolve...Full time
$120k - $150k
...our mission. ABOUT THE JOB As our Senior Payments Operations & Fraud Analyst, you'll be the first dedicated owner of payments... ...manages and addresses risk exposure across the business Lead investigation and analysis of emerging risk areas; partner with Operations and...Full timeLive outFlexible hours- Novig, located in New York, New York, is seeking a Fraud and Risk Specialist. The successful candidate will investigate multi-accounting, bonus abuse, and suspicious betting patterns, ensuring marketplace integrity. This full-time role offers a salary between $65K-$75K...Remote jobFull time
- MaziCTools is looking for a Full-time Fraud and Chargeback Analyst, responsible for identifying fraudulent activities and optimizing chargeback processes. This position allows for a remote-first approach and embraces a collaborative and diverse culture. The ideal candidate...Remote jobFull time
- CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit. The role focuses on complex national healthcare fraud investigations across multiple lines of business, including Medicaid-related matters. You will conduct research, perform data mining...
- Highmark Health is seeking an experienced professional to develop and maintain the organization’s anti-fraud program, conduct investigations into fraud, waste, and abuse, and coordinate with law enforcement when needed. The role includes field investigations, interviews...
- The University of Massachusetts Medical School seeks a Fraud Investigator II in Healthcare to combat fraud and abuse within the Medicaid program. This role involves data analysis and collaboration with senior investigators to develop detection algorithms and communicate...Work at officeRemote workFlexible hours
- ...impact the roadmap and vision of our company. About the Team The fraud risk management team at Rain creates sophisticated, scalable... ...and customers. Create ad hoc data pulls with SQL for anomaly investigation and analyze the results for fraudulent activity. Document...Work at officeWork from homeWork visaFlexible hours
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