Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

CA Healthcare Fraud Investigator | Data-Driven Claims

$56.2k - $101k

Centene

Centene, located in Topanga, California, seeks a healthcare fraud investigator to conduct thorough investigations of potential fraud and abuse. The role demands a Bachelor’s degree and at least 1 year of relevant experience. You will analyze claims data, develop reports, and provide updates on ongoing investigations. The position offers a comprehensive benefits package and a pay range of $56,200 to $101,000 annually, with various work schedule options including remote and hybrid. #J-18808-Ljbffr Centene

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the CA Healthcare Fraud Investigator | Data-Driven Claims in Topanga, CA vacancy
  •  ...Role: Join MedPOINT Management as a Claims Processor in Sherman Oaks, CA, where you will play a crucial role...  ...activities. Analyze claims data to identify trends and areas for improvement...  ...Management has been a leader in healthcare management for over a decade, providing... 
    Data
    Claims
    Work at office
    Remote work

    MedPOINT Management

    Sherman Oaks, CA
    4 days ago
  •  ...AI Functional Consulting And Data Strategy Collaborate with AI...  ...Space Solid understanding of the healthcare payer ecosystem, including...  ...services, provider interactions, claims lifecycle, and care management...  ...health transformation, and AI-driven analytics in payer operations.... 
    Data
    Claims

    E-Solutions

    Encino, CA
    5 days ago
  •  ...Business Systems Analyst (Data & Analytics) Location: Woodland Hills, CA (Remote/Hybrid) Type:...  ..., preferably within the Healthcare / Pharmacy (Rx) domain....  ...business objectives and data-driven decision making. Key...  .../ PBM / Rx datasets (claims, benefits, membership, provider... 
    Data
    Claims
    Contract work
    Remote work

    JConnect Infotech

    Woodland Hills, CA
    5 days ago
  •  ...Business Systems Analyst (Data & Analytics)...  ...Location: Woodland Hills, CA (Remote/Hybrid) Type:...  ...preferably within the Healthcare / Pharmacy (Rx) domain....  ...business objectives and data-driven decision making....  ...Healthcare / PBM / Rx datasets (claims, benefits, membership,... 
    Data
    Claims
    Contract work
    Remote work

    3B Staffing LLC

    Calabasas, CA
    2 days ago
  •  ...Claims Operation Assistant Location: Chatsworth, CA Duration: 5 - 6 Months Visa: GC or USC Need to ensure candidate is proficient in various MS applications...  ...other activities. Compute, record and proofread data and other information, such as records or reports.... 
    Data
    Claims
    Work at office

    Georgia IT, Inc.

    Chatsworth, CA
    2 days ago
  • $90k - $100k

     ...in Woodland Hills, CA. This is a high-...  ...operations, analyzing data, solving problems,...  ...and virtual healthcare access ~ Optional...  ...analysis Review and investigate freight invoices...  ...mill and vendor claims and support monthly...  ...priorities in a deadline-driven environment... 
    Data
    Claims

    Silgan

    Woodland Hills, CA
    4 days ago
  • $24 - $31.25 per hour

     ...Insurance Collector I with prior healthcare collections experience for our main office in Chatsworth, CA. Job Summary: The Insurance...  ...Experience in healthcare claims processing and collections Knowledge...  ...UBO4 or HCFA 1500 claims and data elements Excellent verbal... 
    Data
    Claims
    Hourly pay
    Full time
    Work at office

    Health Advocates, LLC

    Chatsworth, CA
    2 days ago
  •  ...for this role. Title: Data Scientist...  ...Mason, OH/ Woodland Hills CA Duration: Long...  ...specialized AI agents (e.g., Claims Agent, Eligibility Agent...  ...interactions across multi-turn healthcare use cases. • Build...  ...orchestrated by LLM-driven planning modules to... 
    Data
    Claims
    Immediate start
    Relocation

    3B Staffing LLC

    Calabasas, CA
    3 days ago
  •  ...developing high-performing, persona-driven creative strategy and messaging...  ...insights and performance data into scalable creative systems,...  ..., structure, tone, offers, and claims to inform next steps Translate...  ...in office) based in Calabasas, CA. Compensation and Benefits Compensation... 
    Data
    Claims
    Work at office

    True Classic

    Calabasas, CA
    2 days ago
  • $91.5k - $170.5k

     ...Location: Canoga Park, CA Job Schedule: 9/80:...  ...and analyzes statistical data to determine...  ...suppliers regarding damage claims, rejections, losses, return...  ...purchasing within an MRP (ERP) driven manufacturing...  ...to government security investigation(s) and must meet eligibility... 
    Data
    Claims
    Contract work
    Work at office
    Local area
    Flexible hours

    L3Harris Technologies

    Canoga Park, CA
    4 days ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    1 day ago
  •  ...technology platform that helps healthcare providers get paid...  ...combines software, data, and service into a...  ...seamlessly integrated, AI-driven platform that...  ...efficiently dispute underpaid claims, reduce administrative...  ...coding, debugging, investigation, product exploration,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    2 days ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    1 day ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    2 days ago
  •  ...technology platform that helps healthcare providers get paid...  ...combines software, data, and service into a...  ...seamlessly integrated, AI‑driven platform that...  ...efficiently dispute underpaid claims, reduce administrative...  ...engineering work, investigation, debugging, design, and... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    2 days ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    5 days ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    2 days ago
  • $56.2k - $101k

     ...California* Position Purpose Investigate allegations of potential healthcare fraud and abuse activity....  ...organizing, and executing claims investigations or audits...  ...appropriate party Perform data mining and analysis to...  ...schedules. Location Topanga, CA Equal Employment... 
    Data
    Claims
    Work at office
    Remote work
    Flexible hours

    Centene

    Topanga, CA
    2 days ago
  •  ...when it matters most. Our results-driven, high-performance culture...  ...internal production/profitability data and analysis. Performs other duties...  ..., product management, claims, service ops) to identify and capitalize...  ...(s): Hybrid (Woodland Hills, CA / Phoenix, AZ) (Remote in all... 
    Data
    Claims
    Work at office
    Remote work
    Flexible hours
    Shift work

    Farmers

    Woodland Hills, CA
    3 days ago
  •  ...technology platform that helps healthcare providers get paid fairly in an...  ...Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex...  ...efficiently dispute underpaid claims, reduce administrative burden,... 
    Data
    Claims
    Remote work
    Flexible hours

    Pivotal Health

    Santa Monica, CA
    1 day ago
  • $42 - $47 per hour

     ...Design and execute test strategies for API-driven applications. Perform end-to-end...  ...databases, and UI layers. Validate data extraction and transformation logic,...  ...integration testing. Experience in healthcare domain (claims, benefits, eligibility). Exposure to... 
    Data
    Claims

    Cynet Systems

    Woodland Hills, CA
    3 days ago
  • We are seeking a Healthcare System Analyst with strong experience in payer systems and healthcare...  ...& Enrollment, Provider Contract Pricing, Claims Adjudication, Billing, Appeals, and...  ...Experience with Facets platform, including data models, architecture, and process flows.... 
    Data
    Claims
    Contract work

    ClinDCast LLC

    Santa Monica, CA
    4 days ago
  • $60k - $90k

     ...Water Division for a project in Las Virgenes, CA. Are you someone who flourishes on solving problems? Do you leverage data to make decisions and recommendations? Are...  ...Document control (RFIs, submittals, change orders, claims, etc.) Assisting and supporting project... 
    Data
    Claims
    Full time
    Work experience placement
    For subcontractor
    Internship
    Relocation

    The Walsh Group

    Calabasas, CA
    11 days ago
  • $67.35 - $82.3 per hour

     ...medication experts and trusted healthcare providers reshaping the future...  ...Patient-focused & service-driven - You're committed to making healthcare...  ...challenges, from insurance claims to medication management, with...  ...20505 SHERMAN WAY,CANOGA PARK,CA,91306-03427-05848-S Full... 
    Hourly pay
    Work at office
    Flexible hours
    Shift work

    Walgreens

    Canoga Park, CA
    2 days ago
  •  ...portfolio management with bi-monthly follow-ups, claims resolution and appeals, reporting and...  ...-government AR projects and ensure clean data for management presentations. Explain...  ...models. ~ Strong understanding of healthcare authorization requirements and reimbursement... 
    Data
    Claims
    Daily paid
    Contract work
    Temporary work
    Local area
    Shift work

    Medix

    Van Nuys, CA
    4 days ago
  • $2,464 - $2,621 per week

     ...Operating Room Location: Santa Monica, CA Agency: Fusion Medical Staffing...  ...team to deliver coordinated care Utilize data from surgical preference cards for the surgical...  ...provides career opportunities to healthcare professionals by helping medical facilities... 
    Data
    Full time
    Contract work
    Temporary work
    Immediate start
    Shift work

    TravelNurseSource

    Santa Monica, CA
    2 hours ago
  • $117.5k - $157.5k

     ...ESPN Product & Technology. Santa Monica, CA. Job Summary: Disney+ and Hulu are premium...  ...that takes some serious resourcefulness, driven curiosity and determination to be the best...  ...product developers, designers, technologists, data scientists, and more - all working to... 
    Data

    Payfuture Technologies

    Santa Monica, CA
    5 days ago
  • $61.91k - $118.25k

     ...world. How We Lead UMG's fraud prevention team is leading...  ...role will be responsible for investigating and documenting ongoing...  ...large-scale streaming and social data to identify patterns of suspicious...  ...anomalies. Develop data-driven insights to inform anti-fraud... 
    Data
    Summer work
    Work at office
    Immediate start
    Remote work
    Flexible hours

    Universal Music Group

    Santa Monica, CA
    3 days ago
  • $19.5 per hour

     ...this requisition) : Location US-CA-SANTA MONICA Location Name 8414...  .... Responsibilities If you are driven to succeed, you should join SP+...  ...and services provided and issue claim checks. inspect arriving...  ...part of this process, SP+ retains data relevant to your candidacy, including... 
    Data
    Claims
    Hourly pay
    Temporary work
    Part time
    Relocation
    Flexible hours
    Shift work
    Night shift
    Weekend work
    Afternoon shift

    SP+

    Santa Monica, CA
    2 days ago
  • $90k - $95k

     ...Workers Comp Senior Claims Specialist National Interstate is a member of Great American...  ...you are ready to join an engaging and driven team such as ours, we would love to hear...  ...and leads comprehensive claims investigations to confirm coverage and to determine liability... 
    Claims
    Full time
    Part time
    Seasonal work
    Live out
    Work at office
    Remote work

    Vanliner by National Interstate Insurance

    Encino, CA
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to CA Healthcare Fraud Investigator | Data-Driven Claims. Be the first to apply!