Healthcare Fraud Investigator II (Hybrid)
Elevance Health
Elevance Health is seeking an Investigator II to identify and investigate healthcare fraud cases. This role fosters a hybrid work environment, requiring in-office presence 1-2 days a week, while enabling productivity and work-life balance. The Investigator II will conduct claim reviews, develop investigations across health plans, and work closely with law enforcement. Preferred candidates will have a BA/BS and fraud certification, along with experience in health insurance policies. #J-18808-Ljbffr Elevance Health
$61.5k - $136.1k
...for a dynamic individual to join its Fraud Investigations team! This position will be responsible... ...developing and managing complex, high-impact healthcare fraud investigations resulting in... ...skills. NOTE: this role is hybrid/flex and requires in-office visibility...SuggestedLocal areaWork from homeRelocationFlexible hours3 days per week$78.32k - $128.16k
Anticipated End Date: 2026-06-19 Position Title: Investigator II Job Description: Investigator II Hybrid 1: This role requires associates to be in-office... ...and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid...SuggestedFull timeContract workTemporary workWork experience placementWork at officeLocal areaDay shift2 days per week1 day per week- ...seeking a qualified candidate for a position focused on investigating health care fraud. Responsibilities include handling complex cases, preventing... ...role requires at least three years of experience in healthcare fraud and a Bachelor's degree, emphasizing knowledge in...SuggestedFull time
$85k - $105k
Contact-Government-Services-LL in Nashville, TN is seeking a Healthcare Fraud Investigator to provide essential legal support for government projects. The role involves analyzing data, reviewing financial records, and providing litigation support in healthcare fraud cases...SuggestedWork at office$85k - $105k
Healthcare Fraud Investigator 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...SuggestedFull timeWork experience placementWork at officeLocal area$71.1k - $97.8k
Humana Inc. is seeking a Senior Fraud and Waste Investigator to conduct comprehensive investigations addressing fraudulent practices and misconduct. This remote role involves analyzing complex issues and collaborating with various internal and external partners. The ideal...Remote job- Forensic Accountant Nashville, TN/Hybrid 3+ Months Forensic Accountant to review Commercial Pharmacy billing and payments. The Tennessee... ...accountants are experienced auditors, accountants, and investigators of legal and financial documents that are hired to look into possible...Temporary work
- ...Specialist in Nashville, TN. This role involves performing background investigations, reconciling invoices, and ensuring compliance with all... ...set including problem-solving and critical thinking. With a hybrid work model post-training, responsibilities also include maintaining...
$30 - $35 per hour
A prominent investigation firm in Nashville, TN is seeking experienced Part-Time SIU Investigators to join their team. In this hybrid role, candidates will conduct investigations into suspected insurance fraud while working from home and performing local travel. Responsibilities...Hourly payPart timeLocal areaWork from home- ...Investigator Assistant Locations: Indianapolis, IN and Nashville, TN Hybrid 1: This role requires associates to be in-office 1 - 2... ...checks. Assists in managing fraud hotline calls. Provides... ...and communities and making healthcare simpler. We are a Fortune 25...Temporary workWork at officeLocal area2 days per week1 day per week
- MODEA in Nashville, Tennessee, is seeking a Quality Analyst II who will be responsible for evaluating the quality of digital healthcare products. The role includes conducting strategic risk analysis, diagnosing critical issues, and executing technical performance tests....Flexible hours
$81.07k - $129.71k
...Description We are seeking a Special Investigations Unit (SIU) Investigator to conduct timely and thorough health care fraud investigations on behalf of our Company. Responsibilities... ...certifications such as AHFI (Accredited Healthcare Fraud Investigator), CFE (Certified Fraud...Local areaRemote work- ...Internal Fraud Analyst Asurion is committed to fostering a culture of integrity, accountability, and ethical business practices... ...the organization through proactive fraud detection, thorough investigations, and meaningful collaboration across departments. The Internal...Work experience placement
$156.6k - $215.4k
...advancing modernization, standardization, and the maturity of a hybrid Agile delivery model. This role is accountable for delivering... ...initiatives within large, matrixed organizations Prior experience in healthcare, financial services, or other highly regulated industries...Full timeTemporary workFor contractorsApprenticeshipLocal areaRemote work- Asurion in Nashville is seeking a detail-oriented Internal Fraud Analyst to join their Compliance & Ethics Department. This role focuses on proactive fraud detection and thorough investigations to protect the organization. Candidates should have a Bachelor's Degree or...
- ...Fraud Risk Unit Analyst Thread Bank is a digital-first financial technology community bank that aims to enhance customer engagement... ...Fraud Risk Unit (FRU) Analyst to support the monitoring, investigation, and resolution of fraud cases at Thread. This role is a critical...Interim roleWork at office
- Warranty Claims Investigator Requisition ID: 16496 Location: Nashville, TN, US, 37214 Pay Type: Salary Position type: Full-time / Salary COMPANY OVERVIEW Amrize is building North America. From bridges and railways to data centers, schools, offices and homes, our solutions...Full timeFor contractorsLocal areaRemote workFlexible hours
- Amrize in Nashville, TN is looking for a Warranty Claims Investigator. This role involves managing warranty claims to protect the interests of Amrize Building Envelope. Candidates need 6 years of roofing or construction experience and preferably 2 years in warranty claims...Remote job
- ...Elevate is part of the Amrize family of brands. Visit ElevateCommercialBP.com to learn more. We’re seeking a Warranty Claims Investigator who’s ready to be part of a people-first company offering best-in-class products, exceptional training, and deep industry pride—...For contractorsRemote workFlexible hours
- A national investigative services firm is seeking a meticulous SIU Investigator in Nashville, Tennessee. The candidate will conduct thorough investigations into potential fraud and misconduct, requiring strong analytical and communication skills. Responsibilities include...
- ...accordance with established protocols. Offer emotional support and appropriate referrals for ongoing care. Work collaboratively with healthcare teams, law enforcement, and advocacy organizations. Qualifications Active APRN licensure. Experience in sexual assault care or...
$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 jobHourly payPart timeWork at office- Position Summary Assists with the investigation of deaths reported to the Medical Examiner, particularly as regards the seeking, gathering, and documentation of pertinent circumstantial, historical, and other medicolegal data. Aids the Medical Examiner with identification...Work at office
- ...Wayspring's mission and reputation by ensuring we are trusted, audit-ready, and confident in how we safeguard data. This leader owns our healthcare compliance and security assurance programs - including HIPAA, HITRUST, and vendor risk - and serves as the clear point person for...Temporary workInterim roleWork at office
- Thread Bank in Nashville, TN, is seeking a motivated Fraud Risk Unit Analyst to support fraud monitoring, investigation, and resolution. As part of the Financial Crimes Compliance team, you'll help detect and mitigate fraud while managing complex investigations including...
- Thread is seeking a motivated Fraud Risk Unit Analyst based in Nashville, TN. This critical role in the Financial Crimes Compliance team focuses on monitoring, investigating, and resolving fraud cases to enhance the bank's fraud program. The ideal candidate will have over...
- ROSTR, Inc. is seeking an investigative analyst to monitor and analyze streaming data for fraud detection. The role requires 2-5 years of relevant experience and strong data literacy, particularly with SQL and Python. Responsibilities include identifying suspicious behavior...Remote workFlexible hours
$61.91k - $118.25k
...requirements, please seek the advice of legal counsel.Streaming Fraud Data Research & Analyst page is loaded## Streaming Fraud Data... ...copyright fraud. This analyst role will be responsible for investigating and documenting ongoing patterns of suspicious behavior related...Summer workWork at officeImmediate startRemote workFlexible hours- ...organizing workload, submitting examination findings, and corresponding with the Quality Assurance Team. • Collaborate with Healthcare Professionals: Coordinate and collaborate with other healthcare professionals, specialists, and experts as needed to obtain...For contractorsFor subcontractorWorldwideMonday to Friday
- A leading medical examination organization in Nashville, Tennessee, is seeking an individual to assist with death investigations. The role involves gathering and documenting pertinent medical and circumstantial data, inspecting and examining scenes, and communicating with...
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