Healthcare Fraud Investigator
Highmark Health
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 with providers and members, and preparation for court testimony. The ideal candidate will have at least 3 years in healthcare fraud investigations, strong data-mining capability, and excellent communication skills to testify and #J-18808-Ljbffr
- ...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...Suggested
- 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...SuggestedRemote work
$85k - $105k
...range $85,000.00/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...SuggestedFull timeWork experience placementWork at officeLocal area- ...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...Suggested
- Humana is seeking an experienced Healthcare Investigator to join its Special Investigations Unit (SIU). You will conduct investigations of fraud, waste, and abuse in Medicare, Medicaid, and commercial programs, collaborating with members, providers, and law enforcement...SuggestedRemote job
- Leading complex fraud investigations in healthcare billing, coding, and claims, the full-time remote Senior Fraud Investigator will analyze large data sets to identify patterns of fraud, prepare detailed reports, and collaborate with clients and internal teams while mentoring...Full timeRemote work
- Conducting detailed investigations into potential fraud, waste, and abuse in healthcare claims, the full-time remote Special Investigator will review medical records and claims data, collaborate with internal teams, and prepare comprehensive reports for compliance and recovery...Full timeRemote work
- ...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
$77 per hour
Job Description Job Description Medical Disability Examiner (MD/DO/NP/PA) Ithaca, NY POSITION SUMMARY W are seeking independent contractors (1099) Physician (MD/DO), Nurse Practitioners (NP), or Physician Assistants (PA) to join our growing network to conduct...Contract workFor contractors- ...Officers assist other Local, State and Federal police officers with investigations and may collect evidence, question witnesses or testify in... ...looking to take your career to new heights with a leader in healthcare? SUNY Downstate Health Sciences University is one of the...Permanent employmentFull timeLocal areaShift work
$60k - $87.4k
...Description This job is responsible for investigating and analyzing complex, multi-discipline... ...investigation unit (SIU) for potential fraud. This role typically handles a... ...VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro...Work at officeWork from homeVisa sponsorshipWork visa$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 employmentFull timeTemporary workWork at officeRemote workWeekend work- Sexual Assault Forensic Examiner Under clinical oversight, Sexual Assault Forensic Examiner (SAFE), serves as part of the Sexual Assault Response Team (SART) and performs forensic evidence collection for patients who report sexual assault, including evaluation and referral...Full timeWork at office
- ...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...Work experience placementRemote work
$125k - $170k
...results all within a collaborative, employee-focused work environment that is friendly, fair, and flexible. Our work is improving healthcare outcomes, increasing national security, and advancing our national computing infrastructure. Our customers and collaborators...Contract workTemporary workWorldwideFlexible 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- ...building the future, today. About the Role As our Senior Fraud Analyst for Consumer Lending , you will be the gatekeeper... ...team to build, optimize, and scale automated block and manual investigation policies. Advanced Risk Tooling: Liaison with the central...Remote work
$66.96k
...Office of the New York State Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) seeks forensic accountants/auditors (... ..., nurses, and legal support analysts to conduct complex healthcare fraud investigations. The Medicaid program provides health coverage to millions...Work experience placementWork at officeLocal areaRemote workFlexible hours$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...Work experience placementLocal areaFlexible hoursNight shift$27 - $33 per hour
...Job Type 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 investigation...Hourly payPart timeSecond jobWork at officeRemote workFlexible hoursNight shift- ...assigned research project under the supervision of the Principal Investigator or a senior researcher. This individual assists in the... ..., education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating...Hourly payTraineeshipLocal area
- ...assigned research project under the supervision of the Principal Investigator or a senior researcher. This individual typically conducts... ..., education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in...Hourly payTraineeshipLocal area
- ..., education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating... ...funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges....Hourly payTraineeshipLocal area
- Dependable Evaluations in Brooklyn is seeking an experienced phlebotomist to join the ExamOne team. The role is based in NYC, with work across the main boroughs of Brooklyn, Queens, and Staten Island. You will collect specimens, follow safety and quality protocols, and ...
- Job Description Job Description Dependable Evaluations is looking for an experienced Phlebotomist to join our team at ExamOne Brooklyn. Location: ~ Our main 3 Boroughs in NYC are Brooklyn, Queens, & Staten Island. If you are an experienced Phlebotomist ...
- 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
$175k
...-running data provider in the category. Turing also works with Fortune 500 enterprises across financial services, life sciences, healthcare, retail, automotive, and CPG to build and deploy end-to-end agentic AI systems inside mission-critical workflows. By operating on...- Extend is seeking a Fraud Operations Specialist in New York, NY, to join a growing Fraud Ops team. The role involves performing fraud investigations, improving user experience, and collaborating with cross-functional teams to analyze fraud trends. Candidates should have...
- National General Insurance is seeking an experienced SIU Field Investigator to join our Special Investigations Unit in New York. This... ...areas. You will conduct complex investigations into potential fraud, gather statements, perform site inspections, and use analytic...
- 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
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