Senior Healthcare Fraud Investigator
Hispanic Alliance for Career Enhancement
CVS Health is seeking a qualified professional to manage health care fraud investigations. This role requires expertise in CPT/HCPCS/ICD coding and 3 years of experience in fraud investigations. You will investigate cases, document findings, and participate in legal proceedings to combat fraud. The ideal candidate will hold a Bachelor's degree and possess strong analytical, communication, and customer service skills. This full-time position comes with competitive pay and a comprehensive benefits package. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
- Blue Cross and Blue Shield of North Carolina is seeking an experienced investigator to conduct fraud investigations and maintain robust documentation. The role requires strong analytical and communication skills, alongside a solid foundation in Medicare billing principles...Senior
- The Hispanic Alliance for Career Enhancement is looking for a full-time professional in Idaho to help investigate healthcare fraud and abuse. This position involves handling complex cases, documenting findings, and interacting with law enforcement agencies. The ideal candidate...SeniorFull time
$46.99k - $122.4k
The Hispanic Alliance for Career Enhancement is hiring for a position focused on investigating healthcare fraud cases. The ideal candidate will have a Bachelor’s degree and at least 3 years of experience in fraud, waste, and abuse investigations. Responsibilities include...SeniorFull time$46.99k - $122.4k
The Hispanic Alliance for Career Enhancement is seeking a professional for health care fraud investigations. The role requires at least three years of experience in related fields and a Bachelor's degree or equivalent. You will investigate and document cases related to...Senior$46.99k - $122.4k
CVS Health is seeking an experienced professional for a full-time role in health care fraud investigations in United States, Kentucky. The position requires a minimum of 3 years of experience in related fields and knowledge of health care coding systems. This role offers...SeniorFull time$46.99k - $122.4k
CVS Health is looking for a skilled individual to manage healthcare fraud investigations in New Jersey. The role entails handling complex cases, facilitating legal proceedings, and working closely with law enforcement agencies. The ideal candidate will have a Bachelor's...SeniorFull time- 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 a...SeniorFull timeWork at office
- 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...SeniorRemote jobFlexible hours
- A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...Senior
- ...Job Description Job Description 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...Full timeWork experience placementWork at officeLocal area
- ...policies. The ideal candidate should have at least three years in retail loss prevention management and strong analytical skills. This position comes with comprehensive healthcare plans, PTO, and educational reimbursement opportunities. #J-18808-Ljbffr Housing Works Inc.Senior
$81k - $123k
...Adjuster experienced in handling General Liability claims. The candidate should have at least 4 years of experience and strong investigative and communication skills. Responsibilities include evaluating claims, analyzing coverage, and guiding clients through the claims...SeniorFull time$85k - $105k
A governmental support organization is seeking a Healthcare Fraud Investigator to provide legal support for a large government project in Nashville, TN. The ideal candidate will have a four-year degree, three years of relevant experience, and proficiency in data analysis...Work at office- UnitedHealthcare is looking for an Investigator responsible for identifying and investigating healthcare fraud, waste, and abuse. You will analyze claims data, conduct field investigations, and ensure compliance with federal and state regulations. The ideal candidate should...Remote job
- A government services contractor is seeking a Healthcare Fraud Investigator to provide legal support on a large Government project. You will analyze data, review financial and legal documents, and support the development of case referrals. Candidates should have a relevant...Full timeFor contractorsWork at office
- A government services firm in New York is seeking a Healthcare Fraud Investigator to provide legal support for government projects. The role requires proficiency in Microsoft Office and a bachelor's degree in a relevant field, along with three years of investigative experience...Full timeWork at office
- Municipal Credit Union in New York is seeking a Digital Fraud Investigator to safeguard the organization from digital fraud threats. The role involves investigating suspicious activities and collaborating with various teams to enhance fraud prevention strategies. The ideal...Senior
- ...Senior Fraud Specialist About Us: Small businesses are the backbone of the US economy, comprising almost half of the GDP and the... ...a Senior Fraud Specialist who understands how to perform an investigation to mitigate fraud risk About the Role: Daily fraud reviews...SeniorFreelance
$50k - $70k
A leading insurance audit team is looking for experienced premium auditors in the United States. The position offers a competitive total compensation package, including an hourly base wage plus production bonuses that can total between $50K–$70K in the first year. Key ...SeniorHourly payRemote workWork from home- ...A next-generation payments platform is seeking a Fraud/Risk Analyst to join its Risk & Compliance team in New York. The role focuses... ...position offers the opportunity to build a robust fraud detection framework and work closely with senior leadership. #J-18808-Ljbffr...Senior
- ...RELX INC is seeking a Senior Fraud Analyst responsible for providing investigative and analytical support to clients. This role involves analyzing data, developing methodologies to assess risk, and utilizing SQL and programming skills. A Bachelor's degree and 5+ years...SeniorRemote work
- CCSi in New York seeks a financial services leader to enhance fiscal strategies for human-centered organizations. The role emphasizes collaboration with executive leaders, mentoring staff, and ensuring exceptional client service. Candidates should possess an advanced degree...Senior
- ...We are the first line of defense against fraud and abuse on the Plaid platform. Our... ...platform for consumers and customers. As a Senior Fraud and Abuse Operations Analyst ,... ...for responding to fraud and abuse events, investigating claims, and triaging incidents. We also...SeniorWork experience placementLocal area
$70k - $90k
...A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and abuse through data analysis. This remote position requires a Bachelor's degree, 5-8 years of experience in healthcare FWA investigations, and advanced...SeniorRemote work$150.5k - $204k
...prosperity around the world. We are seeking a Senior Business Data Analyst as part of our... ...analyst will work across functions (Fraud & Risk Operations, Data Science,... ...efficiency, customer experience and agent investigation capabilities. In addition, the candidate...SeniorTemporary workWork experience placementSelf employmentLocal area$199.5k - $270k
...We are seeking a Senior Staff Analyst to join the QuickBooks Risk Management team as a strategic analytics partner supporting our Payments... ...Each product carries distinct risk profiles — real-time payment fraud, payroll disbursement exposure, bill payment authorization risk,...Senior$187k - $253k
...Senior Staff Fraud and Risk Analyst - Fintech Category Security, Risk & Fraud Location New York, New York Job ID 20148 Company Overview... ...applicable regulations. Responsibilities Fraud Detection & Investigation Monitor alerts and analyze real-time signals to detect suspicious...SeniorRemote workWorldwide- ...in New York seeks a Clinical Certified Coder to support fraud detection and investigations in the Special Investigations Unit. The successful candidate... ...skills, communication, and integrity in handling sensitive healthcare information. #J-18808-Ljbffr MetroPlusHealth
$70k - $90k
...Senior Investigator - Pre-Pay (Healthcare FWA) Job Location: US-Remote Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is...SeniorWork experience placementWork at officeRemote workWork from home- # Senior Associate / Principal - Healthcare VCPrimetime PartnersPrincipalVenture CapitalOn-siteLocationNew York, United StatesDate PostedJune 11, 2026RegionAmericasStay ahead of the marketGet instant notifications when new job openings matching "Venture Capital / Principal...Senior
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