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
$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- ...a comprehensive anti-fraud program driven by advanced... ...on identifying, investigating and mitigating fraud,... ...support consistent case management, reporting, and outcome... ...performed in an office or remote setting Travel... ...relevant experience, skills, seniority, performance, shift,...Remote workSeniorFraudFull timeWork experience placementCasual workWork at officeShift work
$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
- 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
- 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
- ...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
...View, CA campus. We are seeking a Senior Manager to be a part of our Trust Investigations team, a group of experts focused... ...across the Bay Area and remote locations throughout the United States... ...leading security, threat intelligence, fraud, or investigations teams and...Remote workSeniorFraudFor contractorsWork at officeFlexible hours$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$46.99k - $122.4k
...family and one community at a time. The SIU Senior Investigator conducts complex investigations to... ...and prosecution of healthcare fraud and abuse, to recover lost funds, and... ...multi-disciplinary provider groups in a prepayment environment Investigates to prevent...SeniorFraudHourly payFull timeTemporary workLocal 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
- Travelers Insurance in North Carolina is seeking a meticulous SIU Investigator to manage insurance investigations focused on uncovering fraudulent activity. The ideal candidate will utilize analytical skills and problem-solving techniques to analyze claims and provide...SeniorFraud
$78.68k - $132.69k
ICW Group is seeking a Senior Special Investigation Unit (SIU) Investigator responsible for detecting and investigating fraudulent claims across various insurance lines. This role requires strong analytical skills and a minimum of 5 years of experience in investigations...SeniorFraud$70k - $117k
Kemper is seeking a SIU Investigator III based in Miami, Florida, responsible for investigating complex claims that may involve fraud. This remote position requires the investigator to reside in the Miami Dade area and to conduct comprehensive investigations, collaborate...Remote jobFraud$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$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
- ...Origin is seeking an experienced SIU Investigator to join our growing team in Las Vegas, Nevada... ...investigators with experience handling insurance fraud investigations, obtaining statements,... ...working independently in the field, managing multiple investigations simultaneously,...Remote workFraud
$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- ...military spouses. USAA roles may offer remote or hybrid flexibility for active-... ...needs. The Opportunity As a dedicated SIU Major Case Manager (Medical Provider) , you will be... ...for operational management of Claims fraud investigative teams. Directs staff in the investigation...Remote workFraudH1b
$46.99k - $112.2k
Position Summary We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), Self‑Funded investigations team. In this role, you will manage complex investigations into suspected and known acts of healthcare fraud...SeniorFraudHourly payFull timeTemporary workWork experience placementLocal areaWork from home- Crains Cleveland is seeking an experienced fraud investigator for a role focused on analyzing behaviors related to fraud, waste, and abuse (FWA) in healthcare. The position requires 5+ years of experience in fraud investigations, a high school diploma, and relevant certifications...Remote jobSeniorFraud
- Praescient Analytics is seeking a Senior Investigative Analyst to assist in federal fraud detection and program integrity initiatives. Candidates should possess strong analytical problem-solving skills and a minimum of three years of experience investigating complex fraud...Remote jobSeniorFraud
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