Clinical Fraud & Coding Lead, SIU
MetroPlus
MetroPlusHealth is looking for a Clinical Coder in New York. This role involves reviewing medical records and healthcare claims for compliance, conducting audits, and collaborating on fraud investigations. Candidates must have a minimum of 5 years' experience in healthcare fraud detection and a related bachelor’s degree. AAPC Coding certification is required, along with strong analytical and communication skills. Join a dedicated team that values integrity and trust in delivering quality healthcare services. #J-18808-Ljbffr MetroPlus
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- ...investigative services for insurance claims including workers' compensation and fraud. The ideal candidates should possess strong investigative techniques and must be able to conduct surveillance, complete SIU investigations, and communicate effectively with case managers while...FraudFlexible hours
$100k - $130k
Justia Inc. is hiring an SIU Litigation Attorney for its New York offices. The ideal candidate will have a passion for fraud prevention in the insurance sector and at least one year of litigation experience. Responsibilities include litigating fraud actions, preparing legal...Fraud- ...This role involves investigating various insurance claims including fraud and liability, offering flexible hours for licensed candidates.... ...will perform surveillance and Special Investigations Unit (SIU) assignments, ensuring adherence to instructions while maintaining...FraudRemote jobFlexible hours
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...and prevent fraudulent claims for Great American Insurance Group's SIU. This fully remote position allows for up to 30% business travel.... ...and has 3 to 6 years of experience in Criminal Investigation or Fraud Detection. The salary ranges from $67,000 to $79,000 and includes...FraudRemote job$25 - $30 per hour
Ethos in New York seeks a Special Unit Investigations (SIU) Field Investigator to conduct thorough field investigations, gather and analyze evidence related to insurance claims. Responsibilities include on-site accident investigations, interviewing witnesses, and drafting...FraudHourly pay$20 - $27 per hour
Join to apply for the SIU Investigator Bronx, NY role at ISG 2 days ago Be among the first 25 applicants This range is provided by ISG... ...services firm specializing in cost containment and anti-fraud related services. We are dedicated to maintaining the highest standards...FraudFull time- RELX INC is searching for an Engagement Manager in the United States to oversee the delivery of complex, contracted professional services to clients. The role demands strong project management skills, excellent communication abilities for interacting with clients and stakeholders...Fraud
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A leading analytics firm is seeking a professional with 5 years of experience in the Credit space to join their team. This remote position focuses on conducting client calls, discussing fraud strategies, and supporting the sales team with analyses. Candidates should possess...FraudRemote job- OKX in the United States is seeking a highly motivated Fraud Risk Lead to optimize their global fraud risk management program. The ideal candidate will have 5+ years of experience in fraud risk management, particularly in payments or crypto. Responsibilities include advising...Fraud
- A leading off-price retail store is seeking a Shortage Control Lead in New York. This role involves mitigating theft and fraud while promoting a safe store environment. The ideal candidate will engage with customers positively and assist in training associates on shortage...FraudFlexible hours
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...efforts. The ideal candidate has 5 years of experience in the credit space, strong analytical and communication skills, and a passion for fraud and identity topics. This position offers a competitive salary between $160,000 and $190,000 annually, plus equity and benefits. #J-...FraudRemote job- Estée Lauder Companies is seeking a Forensics Senior Manager to lead high-risk forensic investigations across the Americas, with a focus... ...have significant experience in forensic investigation and fraud prevention, alongside relevant educational qualifications. Excellent...Fraud
- PowerToFly is seeking an Assistant Vice President in New York to join the External Fraud Risk Team. You will manage and enhance fraud rules, conduct analytics, and support fraud incident investigations to protect client data. This role demands 3-5 years of experience, strong...Fraud
$18 per hour
Hunter Super Techs - TurnPoint is seeking a Shortage Control Lead in New York, NY, to combat theft and fraud in our retail store. This role involves engaging customers positively, maintaining a secure environment, and leading training in shortage reduction. Ideal candidates...FraudFlexible hours- Plaid in New York is seeking a Senior Fraud and Abuse Operations Analyst to safeguard our platform against fraud. You will support incident response, drive investigations, and provide insights that shape our product strategy for fraud mitigation. The ideal candidate will...Fraud
$103.97k - $155.95k
...implementation of insider risk detection rules. This individual will engage with various teams to ensure effective monitoring against internal fraud. Ideal candidates will have 5 to 8 years of relevant experience, ideally within regulated environments, and possess a solid grasp of...Fraud$115.4k - $192.3k
RELX INC is seeking a player/coach for its Fraud & Identity Solutions Consulting team. In this role, you will support pre-sales for top strategic clients in North America. Responsibilities include leading solution designs, client assessments, and team mentorship. Ideal...Fraud$180k - $300k
...is seeking an Associate with 3 to 5 years of experience in plaintiff-side securities litigation. The role involves major securities fraud class actions and demands strong brief-writing skills and strategic judgment. The firm offers a competitive compensation package ranging...Fraud- A leading mobile gaming company is looking for a Manager of Analytics based in New York. This hybrid role involves managing a team to provide insights on fraud and payments while working across various areas such as compliance and responsible gaming. The ideal candidate...Fraud
- Burlington Stores in New York seeks a Shortage Control Lead to help mitigate theft and fraud in the store. The role involves engaging with customers and staff, maintaining a safe environment, and supporting store leadership with training and oversight of shortage prevention...FraudFull timeFlexible hours
- ...seeking a skilled Claims Manager. The role involves providing advice to policy holders on claims, investigating claims to identify fraud, and ensuring fair settlements. The ideal candidate will hold a NY Property and Casualty License and be proficient in EPIC. This role...Fraud
- ...PTP Disbursements Lead A leading digital streaming network seeks a PTP Disbursements Lead to oversee enterprise-wide payment operations... ...robust payment governance frameworks, including SOX compliance, fraud prevention measures, segregation of duties, positive pay...FraudShift work
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Intuit is hiring a Staff Analyst, Fraud Policy in New York City to lead policy decisions across Credit Karma's money movement products. This role involves detecting emerging attacks, managing fraud investigations, and collaborating with teams across engineering and compliance...Fraud
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