Elite Medicaid Fraud Investigator
State of Texas
The Office of the Texas Attorney General, Medicaid Fraud Control Unit (MFCU), seeks a Sergeant to lead advanced criminal investigations into Medicaid provider fraud and nursing home cases. You'll coordinate with federal and state partners and assist in prosecutions as needed. Requirements include a high school diploma or 60 college hours with four years of investigative experience, knowledge of healthcare fraud statutes, and strong written/oral communication skills. #J-18808-Ljbffr State of Texas
- Humana Inc. is seeking a Fraud and Waste Professional who will conduct comprehensive investigations of suspected fraud in Medicaid-related processes. The role involves on-site audits, evidence preservation, and collaboration with law enforcement to support adjudication....SuggestedRemote job
- .... The Sergeant position involves advanced criminal investigations of Medicaid provider fraud and nursing home related investigations for the Office of the Attorney General¿s Medicaid Fraud Control Unit (MFCU). Work involves conducting criminal investigations of violations...SuggestedFull timeWork at officeRelocationNight shift
$65k - $88.6k
Become a part of our caring community The Fraud and Waste Professional is responsible for conducting comprehensive investigations of reported, alleged or suspected fraud involving South Carolina's Medicaid Program. The Fraud and Waste Professional coordinates investigation...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$20 per hour
...team looking for candidates who can apply a diverse toolkit of data analysis, internal and open-source tools, and investigative work to combat payments fraud and protect Metas users and business partners. Looking for agents to support our team and directly work with end...SuggestedContract workTemporary workWork experience placementRemote work- ...Job Description Job Description Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support... ...the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data). - Communication skills: Ability to interact...SuggestedFull timeWork experience placementWork at officeLocal area
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$3,000 - $4,999 per month
...HHS webpage . Functional Title: Claims Investigator Job Title: Investigator II Agency: Health... ...of HHS programmatic services, such as Medicaid; the Children’s Health Insurance Program... ...responsible for investigating referrals of fraud, waste, and abuse by HHS clients;...Full timeTemporary workPart timeWork at officeRemote workShift work$32.03 - $45.7 per hour
...available Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-... ...Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust...Remote jobHourly payPermanent employmentFull timeTemporary workLive inCurrently hiringShift work- Health & Human Services Commission (HHSC) in El Paso, TX seeks an Investigator II for the Benefits Program Integrity unit. You will conduct moderately complex investigations into recipients of Medicaid, CHIP, SNAP, TANF, and WIC, gathering evidence, reviewing records, and...
$75k - $110k
If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Staff or Senior Forensic Accountant TX, US 30+ days ago Requisition ID: 1069 Salary Range: $75,000.00 To $110,00...Work experience placementLocal areaFlexible hoursNight shift$59.47k
..., or update your information by visiting and logging into the careers section of the system. Job Description: At Regions, the Fraud Data and Analytics Analyst transforms data into a meaningful format for operational and/or decision-making purposes, with a specialization...Full timeWork at officeRemote workWork from homeVisa sponsorshipWork visaFlexible hours3 days per week- ...First American is seeking an experienced Fraud Investigator to lead investigations, coach team members, and coordinate cross-functional fraud responses in a high-volume environment. Ideal candidates bring 5+ years in fraud investigations, real estate/escrow experience...
- Regions Bank is seeking a Fraud Data and Analytics Analyst to transform data for operational decision making with a focus on fraud threats. You will work with senior analysts and managers to deliver insights that help protect the bank from losses. The role emphasizes data...Remote job
$28 - $38 per hour
...gives people the confidence to reach further. Overview We are currently seeking a Senior Fraud Analyst. The Senior Fraud Analyst will be responsible for identifying, investigating and mitigating potential fraudulent activity involving users of our new online and mobile...- TEKsystems is seeking a remote fraud analyst to join an operations team focused on payments fraud, protecting Meta users and partners... ...tickets while applying a diverse toolkit of data analysis and investigative work. The role requires 3+ years in fraud investigations or...Remote job
- ...support. Responsibilities include analyzing financial information, assisting with litigation discovery, and playing a key role in fraud investigations. Candidates should possess a Bachelor's degree in Finance or Accounting, along with a minimum of 3 years of relevant...Flexible hours
- Texas Health and Human Services Commission (HHSC) in Austin, TX is seeking a Reimbursement Analyst III to advance non-Medicaid rate setting and policy analysis. You will develop and implement rate methodologies, prepare analyses, and present findings to senior leadership...Remote work
$5,000 - $6,999 per month
Career Opportunities: Reimbursement Analyst III (Non-Medicaid and DFPS Rates) (20662) Posting ID 20662 -Posted 08/26/2026 - Health & Human Services Comm - SP26 DFPS Rate Setting - Business and Financial Operations - Eligible for Telework - c. $5000 - $6999 per month Join...Full timeTemporary workPart timeWork at officeRemote workShift work2 days per week$4,523.16 - $7,253.83 per month
...advancement and more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Reimbursement Analyst I (Non-Medicaid and DFPS Rates) Job Title: Reimbursement Analyst I Agency: Health & Human Services Comm Department: SP26 DFPS Rate Setting Posting...Full timeTemporary workPart timeWork at officeRemote workShift work2 days per week- Health & Human Services Commission (HHSC) in Austin, TX seeks a Reimbursement Analyst III to lead advanced rate analyses for non-Medicaid programs. You will develop methodologies, prepare supporting materials, and present recommendations with minimal supervision. The role...Work at officeRemote work
- ...Sedgwick Claims Management Services Ltd is seeking a Senior Adjuster to investigate complex insurance claims, determine coverage, and negotiate settlements. You will interview claimants, inspect property damage, and prepare detailed reports while coordinating with legal...
- The State of Texas, through the Medicaid Fraud Control Unit, seeks a Sergeant to lead advanced criminal investigations into Medicaid provider fraud and nursing home cases. This role reports to the Office of the Attorney General and involves collaboration with FBI and other...Work at office
- East West Bank is seeking a Senior Fraud Analyst to identify, investigate, and mitigate fraudulent activity across online and mobile banking and related services. The role focuses on detection, case management, and policy enhancement to protect customers and the institution...
$86.8k - $124k
...contributions and puts a premium on work flexibility, learning, and career development. SummaryAs an Advisor Technical Business Analyst - Medicaid FHIR Architecture & Interoperability at Gainwell, you can contribute your skills as we harness the power of technology to help our...Full timeRemote workFlexible hours$85k - $113.3k
...information, please visit What We Do Provide a central resource for fraud-tool escalations, identity-review support, property-owner... ...and works closely with other teams to complete in-depth investigations and support, wire and defalcation mitigation workflow. Assist...Local area- Sentara Health Plans is seeking an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) for a remote role. The position supports remote work with annual travel to Virginia Beach and requires 40 hours per week as a full-time, permanent role. The role...Remote jobPermanent employmentFull time
- The CompanyCommercial and personal line insurance carriers rely on EXL as a key business partner through our Castle High Value and EXL Risk Control service offerings. We offer a variety of field inspection and risk control services to support our clients’ underwriting ...For contractorsWork at officeLocal areaWork from home
$69.4k - $99.2k
...work flexibility, learning, and career development. Senior Medicaid Business Analyst (Configuration & Policy) at Gainwell, supports... ...Testing (UAT). Support defect analysis, root-cause investigation, resolution, retesting, and functional readiness validation....Full timeRemote workFlexible hours- Amrize is seeking a Warranty Investigator to protect the company’s Building Envelope interests by managing warranty claims. The role involves receiving, analyzing, and determining claims based on data from all available resources and negotiating resolutions with contractors...Remote jobFor contractors
- Progressive Insurance is seeking a senior claims specialist to investigate complex and high-risk injury claims, coordinating with police, medical professionals, claimants and attorneys as needed. This role supports determining coverage, liability and the total value of...Full timeWork at officeDay shiftAfternoon shift
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