Senior SIU Investigator Lead — Fraud & Compliance
CareSource
CareSource is looking for an SIU Investigator Lead in Kentucky to act as a primary representative for regulatory bodies. Your role includes ensuring compliance, leading fraud investigations, and using data analytics to detect fraudulent activities. The ideal candidate will have a Bachelor's degree in a relevant field, at least ten years of experience in Healthcare Fraud, and strong analytics skills. Opportunities for bonuses and a comprehensive rewards package are available. #J-18808-Ljbffr CareSource
- 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...SeniorFraud
- CareSource is seeking an SIU Investigator Lead based in Kentucky. This pivotal role involves overseeing fraud investigations and managing regulatory communications with state... ...fraud detection efforts. A commitment to compliance and quality improvement is essential. #J-1...FraudRemote job
$83k - $132.8k
Job Summary The Special Investigations Unit (SIU) Investigator Lead serves as the primary representative of the SIU to external... ...communications to ensure timely compliance with oversight agencies, identify and monitor emerging fraud, waste, and abuse (FWA) trends, and...FraudRemote jobWork experience placementLive inWork at office- Bank of America is seeking a Global Financial Crimes Compliance Investigator in New York City. This role involves performing complex investigations related to fraud, money laundering, and regulatory compliance. The ideal candidate must have at least five years of relevant...SeniorFraud
- A government services provider based in New York is seeking an experienced ACE Investigator to assist with federal fraud investigations. This role requires extensive knowledge of investigative techniques, analytical skills, and proficiency with various databases. The ideal...SeniorFraud
$66.33k - $145.86k
...Resources, LLC is hiring an individual contributor for a role focused on healthcare fraud investigations in New York. This position involves directing investigations, ensuring regulatory compliance, and analyzing data for fraud patterns. A Bachelor's degree and 5+ years in...SeniorFraudFull time$46.99k - $122.4k
...multi-disciplinary provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims committed by insured's... .... Facilitates the recovery of company lost as a result of fraud matters. Assists team in identifying resources and best course...SeniorFraudHourly payFull timeTemporary workLocal area- ...Senior Fraud Specialist About Us: Small businesses are the backbone... ...world, and we're excited to lead the small business banking... ...understands how to perform an investigation to mitigate fraud risk... ...a subsequent action plan in compliance with company policies and procedures...SeniorFraudFreelance
- Citi is looking for a Fraud Ops Sr Analyst in New York City. This senior-level position involves developing fraud management policies and minimizing fraud impact by coordinating with the Operations - Services team. Responsibilities include solving fraud prevention issues...SeniorFraud
$150.5k - $204k
...around the world. We are seeking a Senior Business Data Analyst as part of... ...will work across functions (Fraud & Risk Operations, Data Science, Compliance, Marketing, Product, Finance, etc... ...efficiency, customer experience and agent investigation capabilities. In addition, the...SeniorFraudTemporary workWork experience placementSelf employmentLocal area- ...first line of defense against fraud and abuse on the Plaid... ...consumers and customers. As a Senior Fraud and Abuse Operations Analyst... ...to fraud and abuse events, investigating claims, and triaging incidents... ...effectively with internal Legal, Compliance, Comms and other risk...SeniorFraudWork experience placementLocal area
$135k - $155k
...0.00/yr ABOUT THE ROLE As a Lead Fraud Analyst at Happy Money, you’... ...business cases and present them to senior management. Partner with... ...during fraud incidents, investigations, and root cause analyses. ABOUT... ...Audit Financial Crimes Compliance Analyst Charlotte, NC $170,0...FraudFull timeTemporary workWork at office- 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...SeniorFraudRemote jobFlexible hours
- ...want strategists who can reverse-engineer fraud loops and command AI to automatically... ...America, Snaplii connects consumers with 500+ leading brands across everyday categories -... ...role requires a balance of hands-on fraud investigation, SQL-driven analytics, and collaboration...SeniorFraudWork experience placementWork at officeRelocationRelocation package
$32 - $40 per hour
...Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance... ...for claim investigators, SIU investigators, and surveillance investigators... ...Insurance policies and the components of fraud to determine If claims warrant reporting...FraudWork at officeLocal area$187k - $253k
Senior Staff Fraud and Risk Analyst - Fintech Category Security, Risk & Fraud Location New York, New... ...minimizing fraud losses and maintaining compliance with applicable regulations. Responsibilities Fraud Detection & Investigation Monitor alerts and analyze real-time...SeniorFraudRemote workWorldwide- ...is seeking a qualified individual to manage strategic fraud, waste, and abuse activities. This position requires knowledge in healthcare and compliance, with strong experience in medical claims and investigations. Candidates should have a Bachelor's degree and at least...SeniorFraudRemote jobFlexible hours
$60.2k - $107.4k
Senior Investigator Pharmacy At UnitedHealthcare, we're simplifying the health... ...prevention of healthcare fraud, waste and abuse. The investigator... ...Investigations Unit's (SIU's) case tracking system Collect... ...and abuse referrals Ensure compliance with applicable federal/...SeniorFraudFull timeTemporary workWork experience placementLocal areaRemote work- Job Description We are seeking a meticulous and experienced SIU Investigator to join our team. The ideal candidate will be responsible for conducting comprehensive investigations into potential fraud and misconduct. This role involves a variety of investigative tasks aimed...Fraud
$20 - $27 per hour
Join to apply for the SIU Investigator Bronx, NY role at ISG 2 days ago Be among the first 25... ...specializing in cost containment and anti-fraud related services. We are dedicated to... ...reports with time-stamped photos/videos. Seniority level Mid-Senior level Employment type...FraudFull time$30 - $35 per hour
...self-determined, and highly motivated SIU INVESTIGATORS that would like to join our team of professionals... ...efforts to deter and combat insurance fraud. We have several work from home, part‑... ...the state fraud bureaus for regulatory compliance and criminal prosecutions. The...FraudBi-weekly payHourly payFull timePart timeWork at officeWork from home$26 - $30 per hour
Overview Investigator - Network Services Manhattan, NY area Immediate need... ..., ensuring accuracy and compliance. Must have flexibility to work... ...investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop...FraudHourly payFull timeH1bH2bLocal areaImmediate startWorldwideFlexible hoursNight shift$67k - $79k
Summit Consulting is seeking a Special Claims Investigator to detect and prevent fraudulent claims for Great American Insurance Group's SIU. This fully remote position allows for up... ...experience in Criminal Investigation or Fraud Detection. The salary ranges from $67,000...FraudRemote job- ...Job Description Job Description Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support... ...: - Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3. - Relevant...FraudFull timeWork experience placementWork at officeLocal area
$70k - $90k
...A leading healthcare analytics firm is seeking a Senior Investigator to investigate incidents of healthcare fraud, waste, and abuse through data analysis. This remote position requires a Bachelor's degree, 5-8 years of experience in healthcare FWA investigations, and advanced...SeniorFraudRemote work- Job Overview The Fraud Ops Sr Analyst is a senior level position responsible for contributing to the development... ...Collaborate with fraud operations, investigations, digital product teams, technology,... ...its clients and assets, by driving compliance with applicable laws, rules and...SeniorFraud
- ...General Agency, LLC is seeking a Special Investigations Unit (SIU) Desk Investigator to assist with investigating suspected insurance fraud. This role requires conducting... ...documentation, and analyzing damage while ensuring compliance with industry standards. Candidates must...Fraud
$84k - $105k
...is accountable to analyze, create and deploy the rules, scores, and decisioning logic from both internally and externally developed fraud risk models and applications with the associated outcomes as it applies to decisions rendered to optimize the balance of risk, expense...SeniorFraudHourly payWork at officeImmediate startVisa sponsorshipWork visaFlexible hours$60.2k - $107.4k
A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating complex cases and preparing detailed reports based on findings. Candidates must have a Bachelor's or Associate'...SeniorFraud- The Office of the NYS Comptroller Thomas P. DiNapoli is seeking an Investigator to direct and conduct confidential investigations regarding fraud, waste, and abuse. Candidates should possess at least 8 years of experience as a Police or Peace Officer and significant experience...SeniorFraudWork at officeRemote work
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