Field Investigator for Fraud, Waste & Abuse
CES
CES is seeking an Undercover Field Investigator to collect data for audits and investigations into fraud, waste, and abuse. The role involves reviewing documentation, interviewing involved parties, and communicating with stakeholders to gather information for resolution.
Proactively identify fraud opportunities and ensure regulatory compliance. Responsibilities include conducting fieldwork up to 75%, compiling records, and training other auditors/investigators to improve processes.
#J-18808-Ljbffr- ...CES is seeking an Undercover Field Investigator to collect data/information for audits/investigations concerning fraud, waste, and abuse, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating...Fraud
- ...Description Becker & Company is seeking skilled and experienced Field Investigators to join our team on an "as needed" basis. This role is... ...insurance claims including workers' compensation, suspected fraud, liability and aimed at mitigating expenses for our clients and...FraudFlexible hours
- J T Becker & Co Inc, located in Kentucky, is seeking skilled Field Investigators to join our team on an as-needed basis. This role offers flexible... ...investigative services on various insurance claims including fraud and liability. The ideal candidate should possess a valid...FraudFlexible hours
- J T Becker & Co Inc is looking for skilled Field Investigators in Oklahoma to provide expert investigative services on an as-needed basis. This... ...claims, including workers’ compensation and suspected fraud. The ideal candidates will perform various investigations and...FraudFlexible hours
- J T Becker & Co Inc is looking for skilled Field Investigators across Kentucky, offering flexible hours for licensed individuals. The investigations encompass various insurance claims including fraud and liability. Successful candidates will perform tasks like video surveillance...FraudFlexible hours
- J T Becker & Co Inc is seeking skilled Field Investigators located in Kentucky to serve on an as-needed basis. This role is ideal for licensed... ...services for insurance claims including workers' compensation and fraud. The ideal candidates should possess strong investigative...FraudFlexible hours
- J T Becker & Co Inc is looking for experienced Field Investigators to join their team in Kentucky. This opportunity is ideal for licensed investigators... ...investigative services in various insurance claims including fraud and liability. Investigators will be tasked with conducting...FraudFlexible hours
- J T Becker & Co Inc is seeking skilled and experienced Field Investigators to join our team in Oklahoma on an "as needed" basis. This role is... ...investigative services on various claims, including liability and fraud. The role involves conducting investigations, completing...FraudFlexible hours
- Becker & Company is seeking Skilled Field Investigators for flexible, as-needed work covering insurance claims such as workers' compensation, fraud, and liability. Investigators will perform surveillance, document cases, and compile detailed notes under case manager instructions...FraudFlexible hours
$112.3k - $154k
...Job Description Summary The Principal Investigator is an advanced professional responsible... ...monitoring and enforcement. Familiarity with fraud and cyber threat vectors given the... ..., Business Administration, or a related field, or equivalent combination of education...FraudFull timeTemporary workFor contractorsFor subcontractorLocal areaImmediate start$21.25 per hour
...secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, and resolving theft and fraud to ensure product is available for our guest. They also build relationships inside and outside of Target, including store leaders...FraudHourly payLocal areaFlexible hoursShift workNight shiftDay shift- ...Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate... ...Ethos team is seeking an Experienced Field Investigator to conduct surveillance and investigative...FraudLocal areaNight shiftWeekend work
$68.5k - $102k
...Global Financial Crimes Compliance (GFCC) Investigator performs end-to-end investigations... ...conducts complex investigations, including fraud committed by external parties, securities... ...Qualifications Bachelor's Degree in related field Experience in financial services and/or...FraudWork at officeShift workDay shift- Horizon Blue Cross Blue Shield of New Jersey seeks a Pharmacist leader to oversee the Pharmacy Fraud, Waste and Abuse program. You will coordinate with regulatory agencies, design utilization management edits, and lead audits and staff training to ensure compliance and...Fraud
- ...contract with potential for full-time conversion Location-: Newark, NJ (Hybrid) Department: Data Science Team – Long-Term Care (Fraud, Waste, and Abuse Detection) Description-: The team is seeking a Data Scientist with strong MLOps and full-stack data experience, capable of...FraudFull timeContract work
- ...Associate Fraud InvestigatorThe Department of Finance is responsible for administering the tax revenue laws of the city fairly, efficiently... .... Additionally, the Sheriff's Office conducts criminal investigations of real property fraud, tax crimes, and the trafficking of...FraudWork at officeLocal areaRemote work2 days per week
- ...to improve operations, productivity, and cost efficiency.Investigates complex financial issues that require significant expertise... ...vulnerabilities, weaknesses in internal controls, and potential waste, fraud, or abuse within the organization.Performs other related duties as...FraudLocal areaRemote workRelocationMonday to Friday
- ...a Claims Service Representative III for the Special Investigations Unit to investigate potential fraud across product lines and serve as liaison with law enforcement... ...abilities. Responsibilities include leading field investigations, reviewing suspicious activity, and training...Fraud
- ...training team focused on helping you reach your full potential Fraud Investigator II The Fraud Investigator II role is focused on independently... ...FCU or 3 years work experience in a financial related field such as fraud/loss prevention, BSA/AML compliance, collections...FraudFull timeWork experience placementWork at officeLocal areaRemote workWork from home
$108k - $216k
...Walmart Marketplace by developing technology, processes, and operational capabilities that enable trusted sellers while preventing fraud, abuse, and compliance risks. The team works across strategy, operations, product, engineering, data science, and risk to improve...FraudFull timeTemporary workPart time$50k - $60k
...Company Overview A leading provider of legal operational support, specializing in mass tort, single-event, and abuse litigation dockets, is seeking a Claims Investigator to join their team. The role involves managing the litigation lifecycle from intake to settlement...Work at office- ...the Attorney General is seeking a full-time Assistant Attorney General for the Medicaid Fraud Control Unit in Oklahoma City. The role focuses on prosecuting health care fraud, abuse, neglect, and exploitation within the Medicaid program, in collaboration with federal counterparts...FraudFull timeWork at office
- ...interpretation of customer claims data to assess the customer’s plan performance, trends, savings opportunities, and to identify fraud, waste, and abuse (FWA). By combining clinical expertise, analytical capabilities, and deep understanding of PBM contracts and claims...FraudContract workWork experience placementWork at office
$50k - $72k
...sales channels Recommend refund-versus-contest rules and apply them consistently Keep clean records of every dispute and outcome Spot fraud patterns and raise them before they become losses What we are looking for Authorized to work in the United States Based in the...FraudRemote workNight shiftWeekday work$70.5k - $94.4k
...and interpreting requisite documentation to conduct low level investigations. The incumbent will also support the investigators related to... ...claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution...FraudLive inLocal area$35 per hour
...Scope: Install and assemble domestic water supply, sanitary waste, and vent piping systems Work with copper, PVC, cast iron, and... ...is an EO employer - M/F/Veteran/Disability “ Be Safe” from fraud!Tradesmen International will never ask you to pay for...FraudWork at officeImmediate startDay shift$132k - $264k
...experience in building data science solutions in areas like fraud prevention, forecasting, shrink and waste reduction, inventory management, recommendation,... ..., Computer Science, Information Technology or related field and 5 years' experience in an analytics related field....FraudFull timeTemporary workPart timeFlexible hours- ...Incident Response Team Regional Manager and working with technical leads and other associates, you are responsible for detecting, investigating, and responding to cyber security events in the organization as well as handling technical projects. You are a member of the...Full timeCasual workRemote workFlexible hours
- ...Scrum methodologies.Good to have skills:Experience with payment gateway integration, banking APIs, or core banking systems.Knowledge of fraud monitoring, AML compliance, or risk mitigation in payments.Experience with tools like JIRA, Confluence, Visio, or Lucidchart....Fraud
- ...drive methodologiesDDD, BDD Experience in emerging payments methods and trends liketokenization, block chain, Cypto, NFT, AI & ML in fraud etc. Willing to support both business development (PracticeGrowth) and Capability development (Solutions, resources) Has...Fraud
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