Clinical Fraud Investigator II - Risk & Compliance
Elevance Health
Elevance Health in Wilmington, Delaware, is seeking a Clinical Fraud Investigator II, responsible for analyzing and investigating issues related to fraud and abuse. The role requires an Associate Degree in Nursing and certification as a Certified Professional Coder, alongside a minimum of four years of relevant experience. This position promotes hybrid work, requiring in-office presence 1-2 days per week while supporting work-life balance. Key responsibilities include comprehensive analysis of clinical data and collaboration with internal teams to mitigate risks. #J-18808-Ljbffr Elevance Health
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Clinical Fraud Investigator II - Risk & Compliance in Wilmington, DE vacancy
- Clinical Fraud Investigator II Locations: This role requires associates to be in-office 1-2 days per week... .../or entities that may pose potential risk associated with fraud and abuse. How... ...providers as warranted. Examines claims for compliance with relevant billing and processing...SuggestedWork at officeLocal area2 days per week1 day per week
$103.55k - $172k
A leading financial services firm is seeking an Associate for their Fraud Strategy Team in Wilmington, Delaware. The ideal candidate will enhance fraud strategies, analyze risks, and collaborate with various teams to develop innovative solutions. Required qualifications...Suggested- Nemours is seeking a Constable II to join our team in Wilmington, DE. The Constable II provides protection for staff, patients,... ...exist, and all exterior doors are secure. Prevention, detection, investigation and reporting of unlawful and unsafe activities within the...Suggested
- Nemours Children's Health in Wilmington, DE seeks a Constable II to protect staff, patients and visitors. The role involves armed security, patrols of hospital buildings and grounds, access control, and responding to alarms and emergencies. Requires state constable license...Suggested
- ...Controlled Disbursements Wire Fraud Review Analyst is responsible... ...of Fraud and reputational risk. The position requires work with... ...will focus on research and investigation for the purpose of Suspicious... ...clients and assets, by driving compliance with applicable laws, rules...SuggestedWork experience placement
- Overview A Fraud Detection Specialist I will review alerts/transactions flagged as potentially... ...appropriate action steps to mitigate risk and protect the Bank from financial loss.... .../claims on all suspicious activity and investigate, escalating when needed. Detect various fraud...Contract workWork at office
- A technology solutions provider seeks a Business Reporting Analyst in Newark, DE. This role involves managing Fraud Risk reporting through data analysis and visual presentation. Candidates require 5+ years of experience crafting executive-level data messaging, advanced...Contract work
- ...contacted We are seeking a highly motivated GRC Analyst to support the modernization and transformation of our Governance, Risk, and Compliance (GRC) program. This role is ideal for someone with a strong technical and automation background who is interested in applying...Contract workLocal area
Liberty Personnel Services, Inc.
Wilmington, DE2 days ago - ...Services, Inc. is seeking a motivated GRC Analyst in Wilmington, Delaware, to support the modernization of the Governance, Risk, and Compliance program. The ideal candidate will drive migration from the current Archer platform to a new GRC solution, design automated workflows...
- ...Control Auditor to coordinate and oversee QA activities within the Benefits: Timeliness and Quality (BTQ) program. The role ensures compliance with unemployment laws and accurate data validation. The incumbent will review complex audit findings, validate case...Remote job
- ...Auditor staff and case coding data prior to entry into automated data base. Reviews completed case documents to determine and insure compliance in accordance with Quality Control methodology and that data gathered and conclusions reached are accurate and based upon a...Remote workFlexible hours
- ...services company based in Newark, DE is seeking a Fraud Detection Specialist I to review alerts and... ...assessing suspicious activity, ensuring compliance with established procedures, and working within a team to mitigate risks. Candidates should have a background in banking...Contract work
- A financial services company is seeking a Fraud Investigator Specialist responsible for analyzing client transactions to identify fraud and enhance... ...candidate should have a minimum of 2 years' experience in risk management or fraud functions, strong analytical skills, and...Contract work
- ...clients' transactions identified through fraud operations and strategy to identify rings... ...corporate losses. Additionally, the Fraud Investigator Specialist will quarterback internal... ...strengthen operational processes to reduce fraud risk. Responsibilities Perform analysis on...Contract workRemote workFlexible hours
- ...selection. The candidate is expected to generate hypotheses, influence design decisions, and contribute to advancing programs toward clinical development. Essential Functions Of The Job (Key Responsibilities) Lead and execute computational modeling initiatives for...Work experience placement
Incyte
Wilmington, DE3 days ago $53.96k - $86.18k
...FRAUD TEAM SUPPORT ANALYST WHAT IS THE OPPORTUNITY? Responsible for analytical and project support for Fraud operations, including: conducting analysis of transactional data for fraud trend evaluations, queries to analyze compromises, create and test rules for implementation...Remote workCity National Bank
Newark, DE1 day ago- ...Performing safety audits, safety, and fire prevention and inspections Answering alarm responses Performing insurance inspections and investigations Job Requirements Successful candidates should have effective communication skills and the interpersonal skills to work with...Weekly payTemporary workAfternoon shift
- ...Health and Social Services for clinical nursing positions. New... ...Consultants, Nursing Supervisors, and Compliance Nurses $7,500.00 recruitment... ...years with DHSS. RN Investigator The RN Investigator conducts... ...compact license. Registered Nurse II – Psychiatric Nursing Possession...
DelDOT
New Castle, DE1 day ago - ...including hepatocyte, microsomal, and radiolabeled (e.g., 14C) ADME investigations Perform metabolite identification using LC‑MS/MS and high‑... ...programs through analysis and reporting of preclinical and clinical ADME studies, including mass balance and human ADME studies...Work experience placement
- ...Overview Information Security Governance, Risk and Compliance (GRC) Analyst – Risk and Policy focus. Responsibilities Assist in the execution of the organization’s security risk management program and support the policy governance lifecycle. Lead the execution of security...Contract work
CFC- Chatham Financial Corporation
Kennett Square, PA2 days ago $122.85 per hour
Job Posting Opening Date: 1/22/2026. Closing Date: 7/20/2026 11:59:00 PM Type of Recruitment: Casual/Seasonal. Salary: $122.85/hour. Pay Grade: FR1 Shift Hours: 8:00 am - 4:30 pm M-F, rotating weekend and holiday coverage Employment Type: Actual Vacancy...Casual workSeasonal workWork at officeShift work- CFC- Chatham Financial Corporation is seeking an Information Security Governance, Risk and Compliance Analyst with a Risk and Policy focus. You will be responsible for assisting in security risk management, leading risk assessments, and collaborating with stakeholders to...Contract work
- ..., those who join the Secret Service are courageous, intelligent, strong and determined. A diverse team capable of balancing our investigative mission and fulfilling our protective legacy. Proven to be worthy of trust and confidence. Be tomorrow's Secret Service. Duties...Relocation
The United States Secret Service
Bellefonte, DE4 days ago - M&T Bank is seeking a Cybersecurity Threat Intelligence Analyst to support data collection, alert triage, investigation, and documentation of analyses to defend against cyber threats. The role emphasizes researching third-party incidents, vulnerabilities, malware, and TTPs...
$23 - $24 per hour
...your primary focus is to provide undercover, plain‑clothes surveillance to identify and apprehend shoplifters, deter shoplifting. No risk management, safety, door greeting, alarms, audits, or inventory responsibilities. This position is solely focused on discreetly...Hourly payFull timeLocal areaFlexible hoursWeekend workHobby Lobby
Bear, DE2 days ago$66.04k
...elements of Phase I to be considered for Phase II. All applicants will be contacted... ...evidence obtained during traffic and criminal investigations for prosecution purposes • Deliver... ...reporting safety and/or security hazards or risks • Responsible for the entire arrest...Immediate startShift workRotating shiftDelaware River and Bay Authority
New Castle, DE25 days ago- ...Summary Statement The level I position will perform forensic death investigations to assist in determining the circumstances, jurisdiction, and... ...evidence; photographing the scene and the body. Determines compliance with medicolegal death investigation laws, rules, regulations...Casual workSeasonal workWork at officeRemote workFlexible hoursNight shiftWeekend work
State-of-Delawar
Wilmington, DE1 day ago - Allied Universal is seeking a dedicated Surveillance Investigator in Wilmington, Delaware. In this role, you will perform discreet surveillance... ...claims, ensuring high standards of confidentiality and legal compliance. The ideal candidate will possess a high school diploma, one...
- ...nonpartisan agency to detect and deter fraud, waste, abuse, mismanagement, and corruption... ...This position serves as a lead investigator within the Office of the Inspector General... ...investigations of alleged or probable violations or compliance issues by identifying, obtaining,...Work at officeRemote workFlexible hours
DelDOT
Wilmington, DE1 day ago - ...extramurally-funded research program while maintaining an active clinical practice. The successful candidate will thrive in a... ...and running of the laboratory and assure it is in regulatory compliance. Mentor and train laboratory technicians, graduate, medical and...Full timeRelocation
Nemours-Children
Wilmington, DE3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Fraud Investigator II - Risk & Compliance. Be the first to apply!
Related searches
- fraud manager Wilmington, DE
- fraud prevention Wilmington, DE
- product manager fraud Wilmington, DE
- fraud associate Wilmington, DE
- risk Wilmington, DE
- technology risk Wilmington, DE
- at risk youth Wilmington, DE
- risk assurance Wilmington, DE
- risk compliance Wilmington, DE
- risk and compliance analyst Wilmington, DE