Fraud Investigations Analyst
Virtual Vocations Inc
Conducting fraud, waste, and abuse investigations, the full-time remote Fraud Investigations Analyst will lead quality control efforts, manage regulatory deliverables, and ensure compliance with Medicaid standards while preparing documentation for regulatory inquiries. Key Responsibilities Conduct investigations into suspected fraud, waste, and abuse, including interviewing witnesses and documenting findings Perform quality control reviews of case files and ensure adherence to regulatory requirements and internal protocols Compile and organize response packages for Requests for Information from regulators and maintain tracking logs for deliverables Required Qualifications Bachelor's degree preferred; substantial professional experience may be considered in lieu of a formal degree 5-7 years of experience in LHCSA, MCO/health plan, and/or state regulatory Medicaid roles Prior experience in fraud investigations, program integrity, or compliance auditing required Experience preparing or responding to regulatory RFIs, audits, or corrective action plan documentation preferred Certification such as CFE, AHFI, or CCEP preferred
- ...ensure a bright future for NTT DATA Services and for the people who work here.NTT DATA Services currently seeks a Fraud Detection & Investigation Analyst to join our team in Plano, Texas (US-TX), United States (US).Role Responsibilities:-Assisting in detection and triaging...SuggestedFor contractors
$30 - $35 per hour
...Fraud Investigation AnalystLocation: Charlotte, NC Pay: $30-$35/ hourThis position works to support the enterprise fraud investigation team (EFSI) in developing a best-in-class fraud prevention, detection and response program. This is an entry-level investigator position...SuggestedWork experience placement- ...TP seeks a Fraud Analytics professional to analyze financial data, identify fraud patterns, and develop anti-fraud strategies to... ...with cross-functional teams to resolve complex cases, conduct investigations, and provide guidance on best practices to stakeholders. The role...Suggested
- ...First City Credit Union in Altadena, CA is seeking a Fraud Analyst to review alerts in Verafin and BioCatch, conduct investigations, and document resolutions; collaborate with Finance, Compliance, and Loan Servicing. Candidates should have 3–5 years in fraud prevention...Suggested
$500 per month
...Senior Fraud Analyst – Fraud Investigations & Financial Crimes Monitoring Remote - North America Alpaca is a US-headquartered, global leader in agent-first brokerage infrastructure for stocks, ETFs, options, crypto, fixed income, 24/5 trading, and more. This includes...SuggestedRemote workHome office- Sr Fraud Investigative Analyst conducts meticulous investigation of various potentially fraudulent transactions and develops rules to assist with early fraud detection and prevention. Sr Analyst is responsible for evaluating the circumstances of suspected or confirmed fraud...Flexible hours
- AT&T in Mesa, Arizona is seeking a Fraud Analyst to investigate fraud alerts on residential and business customers. You will use PC systems and AI tools to decide on suspensions, credits, and disputed activity while coordinating with other departments. You will provide...
- Overview A Fraud Detection Specialist I will review alerts/transactions flagged as potentially fraudulent or out of pattern based on... ...financial loss. Open cases/claims on all suspicious activity and investigate, escalating when needed. Detect various fraud schemes (email...Contract workWork at office
- Grey Street Consulting, LLC is seeking a Financial Fraud Analyst to support the United States Attorney’s Office in Newark, NJ. The role... .... Proficiency in Microsoft Excel and familiarity with investigations is essential. The position is full-time on-site. #J-18808-Ljbffr...Full timeWork at office
- DoorDash is seeking a Fraud Insights Operations Analyst, Cx False Positive, to investigate fraud cases and support long-term fraud reduction. The role reports to the Fraud Operations Supervisor and partners with S&O to meet project and analytic needs. The position requires...Work at officeAfternoon shift
$95k - $120k
About the role AIG is seeking a Fraud Investigations Manager who is fluent in English and Spanish (reading, writing, and speaking) to join the Global Investigative Group (“GIG”) team in our New York Office. GIG is a specialized unit within AIG’s Global Legal, Compliance...Full time- ...Work You’ll Do As a Project - Senior Consultant, Forensics and Investigations,on the project, you will: Work independently to solve complex... ...anticipated banking anti-money laundering regulations and practices or fraud detectionAbility to perform job responsibilities within a work...Local area
$68.97k
...State Attorney General is seeking a forensic accountant/auditor for its Medicaid Fraud Control Unit in Albany. This role involves collaboration with attorneys and analysts to investigate complex healthcare fraud cases, ensuring the integrity of New York's Medicaid program...Work at officeRemote work- ...Senior Forensic Accountant to support complex financial investigations involving fraud, waste, abuse, and mismanagement affecting federal benefit... ...alongside investigators, data scientists, investigative analysts, and federal law enforcement partners to develop evidence...Work at officeRemote work
- ...our Team. Specifically, we are presently seeking motivated Investigative Analysts to work with us performing investigative research services in... ...accountabilities include: * Reviewing incident reports, such as fraud and other law violations, strategizing on effective ways to...Contract workWork at officeImmediate start
- ...Digital Federal Credit Union is seeking a Financial Crimes Investigator to conduct investigations into known or suspected fraudulent activity... ...affecting members and the organization. The role analyzes fraud alerts, leads, referrals, and member activity to identify schemes...
- ...Digital Federal Credit Union seeks a Financial Crimes Investigator to conduct investigations into known or suspected fraudulent activity affecting members and products. You will analyze fraud alerts, leads, referrals, and member activity to identify schemes and document...
$102.18k - $163.49k
L.A. Care Health Plan is seeking a Manager for the Special Investigations Unit. This role involves overseeing fraud investigations and managing a team to ensure operational efficiency and compliance. The ideal candidate will have at least 5 years of experience in fraud...Full timeContract work$40 - $49.14 per hour
...Job Description Job Description Cyber Fraud Investigations Analyst Job Details Cyber Fraud Investigations Analyst (Contract) Location: Chicago IL 60611 Duration: 11/10/2025 to 11/09/2026 Team: Global Payments and Billings Key Responsibilities: Investigate...Hourly payContract workWork experience placementRemote workShift work- East West Bank is seeking a Fraud Analyst to join our team in California. The role requires schedule flexibility and occasional extended hours to meet department needs. You will analyze account activity, triage suspicious events, and support cross-functional partners with...
- ...Job Description Job Description Fraud Analyst / Financial Crimes Fraud Investigator Location - Remote and Onsite Thrice a week - Winchester, VA // Pensacola, FL Location : Longterm ongoing with no end date Compensation* Rate : Winchester, VA : Pay Rate...Hourly payRemote workWorldwide
- ...Practical Adult Insights is seeking an Insurance Fraud Investigator in North Carolina to evaluate insurance claims and verify their authenticity. This position entails collecting information about claimants, conducting surveillance, and documenting findings clearly. The...
- ...We currently have a potential vacancy for a Senior Financial Analyst/Investigator. In this role, you will be supporting the overall mission of... ...and prosecutions involving federal fund and program fraud. Analyze and audit program and benefit funding, eligibility...Full timeTemporary workFor contractorsInterim roleWork at officeLocal areaRemote work
$76.6k - $127.6k
...accelerate their path to value creation. Work You’ll Do As a Project - Consultant, Forensics and Investigations on the project, you will address the threats that perpetuate fraud, waste, and abuse, our clients look to our team to provide the guidance and solutions required...Local area- Job Title: Fraud InvestigatorOverview:Financial fraud investigations require experienced professionals who can connect the dots, analyze complex activity, and work with partners across the financial system to resolve cases. German American Bank is seeking a Fraud Investigator...Bank staffLocal area
- We are looking for a Fraud Investigator to support financial crime reviews and investigative work for a long-term contract opportunity based in Phoenix, Arizona. This role is ideal for someone who can assess risk, examine customer and transaction activity, and prepare...Hourly payLong term contractContract work
$90k - $115k
...Description:This job is responsible for performing end-to-end investigations or investigations support functions of external financial crimes... ...conducting routine to complex investigations, including fraud committed by external parties, money laundering, or terrorist...Full timeWork at officeShift workDay shift$72.8k - $130k
...us to start Caring. Connecting. Growing together.The Senior Fraud Analyst is a member of the Bank Fraud team and acts as a subject matter... ...Senior Fraud Analyst will be responsible for reviewing and investigating potential cases of financial fraud on both bank accounts and...Minimum wageFull timeWork experience placementBank staffWork at officeLocal areaRemote work3 days per week$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...Permanent employmentTemporary workWork at office- OH0713 NW Bancshares HQJob DescriptionThe Fraud Analyst is responsible for detecting, preventing, mitigating, and recovering from fraudulent... ...involves triaging reported activity and creating cases for Investigators to ensure timely and accurate escalation of fraud incidents....Full timeWork at office
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