Senior Manager, Prepay Fraud & SIU Investigations (Remote)
Centene Corporation
- Remote job
Centene Corporation in California seeks a dedicated individual to lead strategic fraud, waste, and abuse initiatives within our health plans. In this role, you will manage a team, monitor processes for integrity, and ensure compliance in billing. The ideal candidate holds a Bachelor's degree and has over 4 years of relevant experience, including knowledge of medical terminology and fraud investigation. Join us for competitive pay and a comprehensive benefits package that supports work flexibility. #J-18808-Ljbffr Centene Corporation
$87.7k - $157.8k
Centene Corporation is seeking a qualified candidate to manage strategic fraud, waste, and abuse activities in New York. Responsibilities include... ...billing integrity and leading a team for pre-payment investigations. Ideal candidates should possess a bachelor’s degree and...Remote jobSeniorFraud- Centene Corporation is seeking an Investigator to develop, implement, and manage strategic activities against fraud, waste, and abuse. You will ensure compliance and oversee billing integrity while leading a team in investigations. This role requires a bachelor’s degree...Remote jobSeniorFraudFlexible hours
- ...Corporation in North Carolina is seeking a professional to manage strategic fraud, waste, and abuse activities. This role involves ensuring... ...with state and federal requirements while leading a team to investigate fraud referrals and preparing saving reports. The ideal...Remote jobSeniorFraudFlexible hours
- Centene Corporation is seeking a qualified individual to manage strategic fraud, waste, and abuse activities. This position requires knowledge... ...compliance, with strong experience in medical claims and investigations. Candidates should have a Bachelor's degree and at least 4...Remote jobSeniorFraudFlexible hours
- ## Senior Manager, SIU Fraud InvestigationApplylocations: US DC 9th St NWtime type: Full timeposted... ...analytics and focused on identifying, investigating and mitigating fraud, waste and abuse... ...generally performed in an office or remote settingTravel Requirements:• Travel requirements...Remote workSeniorFraudWork experience placementCasual workWork at officeShift work
$87.7k - $157.8k
...Purpose Develop, implement and manage strategic fraud, waste and abuse activities by... ...Lead a team responsible for investigating fraud, waste and abuse referrals for prepay investigations Develop educational... ...approach to work with remote, hybrid, field or office work...Remote workFraudFull timePart timeWork at officeFlexible hours$70k - $117k
Kemper Corporation is hiring a SIU Investigator III responsible for investigating complex and suspicious... ...and investigative skills. This remote position primarily targets candidates residing... ...contacts, and collaborate with state fraud bureaus. A minimum of four years'...Remote jobSeniorFraudWork at office- 慨正橡扯 is seeking a Senior Manager to oversee financial crime compliance in New York, NY. This... ...have extensive experience in AML and Fraud investigations, excellent communication skills, and the ability to work under pressure. Remote work is not permitted for this role....Remote workSeniorFraudFull time
$32.05 - $57.49 per hour
GEICO is looking for a Senior Internal Security Investigator to conduct investigations on suspected insurance fraud and claims. This fully remote role requires at least five years of relevant experience and the ability to manage multiple investigations effectively. The...Remote jobSeniorFraudHourly pay- ICW Group is seeking a Senior Investigator to join their Special Investigation Unit. The role involves investigating suspected fraudulent claims across various insurance lines. Ideal candidates will have significant experience in investigations, strong analytical abilities...Remote jobSeniorFraud
- GEICO in Los Angeles is seeking a Senior Field Investigator to conduct investigations of suspected fraud involving insurance claims. The role involves interviewing witnesses, gathering evidence, and coordinating with outside agencies, offering an engaging environment focused...Remote jobSeniorFraud
- ...Corp. in California is seeking a qualified candidate to develop and manage fraud, waste, and abuse activities. Responsibilities include monitoring compliance and leading a team focused on investigations, along with preparing savings reports. The ideal candidate has a...SeniorFraudFlexible hours
$155k - $257k
Senior Manager - Trust Investigations We are seeking a Senior Manager to be a part of our Trust Investigations... ...distributed across the Bay Area and remote locations throughout the United States... ...decision‑making for effective fraud and abuse mitigation. Basic Qualifications...Remote workSeniorFraudFor contractorsWork at office$46.99k - $112.2k
...Senior Investigator We're building a world of health around every individual — shaping a more connected, convenient and compassionate health... ...investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high...Remote workSeniorFraudHourly payFull timeTemporary workWork at officeLocal area- Root Insurance is looking for a SIU Field Investigator II to conduct field investigations related to insurance fraud. This role requires strong critical thinking and investigative... ...and provide detailed reports. Root supports remote work across the US, encouraging flexibility...Remote workSeniorFraud
- ...Investigating allegations of potential healthcare fraud and abuse, the full-time SIU Investigator will conduct investigations, perform data analysis, and prepare detailed reports while working remotely, preferably from Ohio. Key responsibilities Conduct investigations...Remote workFraudFull time
- Delta Group, a national investigative firm, seeks a Special Investigation Unit professional to lead claims... ...insurers, law enforcement, and regulators to deter fraud and protect client interests. Ideal candidates have extensive SIU experience, strong analytical and...SeniorFraud
- Blue Cross Blue Shield in Washington, DC seeks a Senior Manager for SIU Fraud Investigation to lead anti-fraud efforts across lines of business. You will oversee strategy, investigations, and reporting, driving improvements through analytics and collaboration with stakeholders...SeniorFraud
$30 - $35 per hour
VRC Investigations is seeking experienced and motivated Part-Time SIU Investigators in New Orleans, Louisiana. These roles allow for work from home or on-site, requiring... ...for investigations into potential insurance fraud. The ideal candidates will have relevant experience...Remote jobFraudHourly payPart timeWork from home$70k - $117k
Kemper Corporation is hiring a SIU Investigator III in Miami, Florida. This role focuses on investigating complex, suspicious claims and coordinating... ..., and proficiency in Microsoft products. The position is remote but requires residency in Miami Dade County for assignments....Remote jobFraud- Safepoint Insurance is seeking an SIU Examiner in Louisiana to identify and handle all aspects of fraud investigations within the Claims Department. You will review SIU reported... ...and the ability to work independently in a remote home-office environment. #J-18808-Ljbffr...Remote jobFraudHome office
- Safepoint MGA, LLC is seeking a highly motivated SIU Examiner to work remotely in Louisiana. This role requires expertise in handling claims fraud investigations, including analysis and recommendation of actions. The examiner will conduct interviews, coordinate with SIU...Remote jobFraud
$28.1 - $42.15 per hour
.../ Days Hybrid or Remote Join a mission‑driven... ...Audit and the Fraud, Waste and Abuse (... ...FWA) Committee for investigations and provider... ...schemes and ensures the SIU processes and... ...cases resulting in a prepayment review. Maintains... ...Project, and database management. Maintain...Remote workFraudDaily paidFull timeTemporary workFlexible hours- Centene Corp. is seeking a full-time SIU Investigator to work remotely in California. This role involves investigating healthcare fraud allegations, performing data mining, and analyzing claims to identify potential abuse. Applicants should possess a Bachelor’s degree...Remote jobFraudFull time
- ...seeking skilled and experienced Field Investigators for a fully remote, as needed position. This role... ...investigating various insurance claims including fraud and liability, offering flexible... ...and Special Investigations Unit (SIU) assignments, ensuring adherence to instructions...Remote jobFraudFlexible hours
$53.5k - $77.8k
...Siu Investigator This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner... ...prevent insurance fraud while supporting... ...communication. This remote opportunity provides... ...$92,700 USD. SIU Senior Consultant I: $68,50...Remote workFraud- JOB DESCRIPTION Leads and manages team responsible for special investigation unit (SIU) activities, specifically the prevention and detection of violation of... ...to maintain and revise policies and procedures, fraud, waste, and abuse (FWA) plans, annual audit work plans...Remote workFraudFull timeWork at office
$30 - $35 per hour
VRC Investigations is seeking experienced Part-Time SIU Investigators to join its team in Las Vegas, Nevada. You will investigate potential insurance fraud, conduct interviews, and document findings in detailed reports. The role requires excellent communication, analytical...Remote jobFraudHourly payPart time$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care... ...prevention of healthcare fraud, waste and abuse. The Senior... ...Special Investigations Unit's (SIU's) case tracking system... ...performance rewards, and a management team who demonstrates their...Remote workSeniorFraudMinimum wageFull timeTemporary workWork experience placementLocal area$70.1k - $126.2k
...professional on our Medical Management/Health Services... ...VP of Compliance Investigations this position... ...and/or senior management regarding... ...People Relations, SIU, Privacy, Finance,... ...Certifications Certified Fraud Examiner (CFE) preferred... ...to work with remote, hybrid, field or...Remote workSeniorFraudFull timePart timeWork at officeFlexible hours
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