Senior Investigator, Fraud & Abuse — Special Investigations
$46.99k - $112.2kCVS
CVS Health is seeking an experienced investigator in Raleigh to conduct complex analyses of Pharmacy and Prescriber behaviors aimed at preventing fraud. The candidate should have experience in healthcare fraud investigations and proficiency in data analysis. This full-time position offers a competitive salary range between $46,988.00 and $112,200.00 along with a comprehensive benefits package, including medical, dental, and vision coverage. #J-18808-Ljbffr CVS Health
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Senior Investigator, Fraud & Abuse — Special Investigations in Raleigh, NC vacancy
$46.99k - $122.4k
...provider groups in a prepayment environment Investigates to prevent payment of fraudulent claims... ...recovery of company lost as a result of fraud matters. Assists team in identifying... ...and prosecution of healthcare fraud and abuse matters. Demonstrates high level of...SeniorFraudHourly payFull timeTemporary workLocal area- ...CVS Health is seeking a Sr. Analyst for Fraud, Waste, and Abuse (FWA) in North Carolina. This position will involve detecting and investigating incidents of FWA by reviewing billing and claims data, ensuring compliance, and coordinating with regulatory agencies. The ideal...SeniorFraudFull time
Hispanic Alliance for Career Enhancement
Raleigh, NC2 days ago - ...this position. The Primary Role The primary role of the Senior Bank Fraud Investigator is to investigate and deter fraud against Ally Bank. This... ...various stakeholders strongly preferred. Knowledge in Elder Abuse and/or Elder Financial Exploitation investigations are...SeniorFraudWork at officeRemote work
- ...are the first line of defense against fraud and abuse on the Plaid platform. Our mission is... ...platform for consumers and customers. As a Senior Fraud and Abuse Operations Analyst ,... ...responding to fraud and abuse events, investigating claims, and triaging incidents. We...SeniorFraudWork experience placementLocal area
Plaid
Raleigh, NC4 days ago - Ally is hiring a Senior Bank Fraud Investigator in Raleigh, NC, to investigate and deter fraud against Ally Bank. This role requires conducting fraud investigations using various analytical tools and presenting findings to leadership. The ideal candidate should have over...SeniorFraud
- Allied Universal in Raleigh, North Carolina, is seeking a Major Case Unit Investigator to investigate insurance claims that suggest fraudulent behavior. This role requires extensive knowledge of insurance policies and the ability to conduct complex investigations across...SeniorFraud
$46.99k - $122.4k
CVS Health is seeking a full-time Healthcare Fraud Investigator located in North Carolina. This role involves managing complex fraud cases, investigating fraudulent claims, and preparing documentation for legal review. Candidates should possess a Bachelor's degree or equivalent...SeniorFraudFull time$30 - $40 per hour
...ABOUT US Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision‑making for...FraudHourly payLocal areaNight shiftWeekend workEthos
Raleigh, NC4 days ago- ...North Carolina is seeking a professional to manage strategic fraud, waste, and abuse activities. This role involves ensuring compliance with state and federal requirements while leading a team to investigate fraud referrals and preparing saving reports. The ideal candidate...SeniorFraudRemote workFlexible hours
Centene Corporation
Raleigh, NC5 days ago - ...with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance... ...insurance policies and the components of fraud to determine if claims warrant reporting... ...for prosecution. RESPONSIBILITIES Use specialized services to identify new and emerging fraud...FraudFull timeLocal area
$107.7k - $199.3k
...sensitive, and high-impact internal investigations across the organization.... ...and the ability to influence senior leadership decisions while... .... Participates in and leads special projects (e.g., auditing, training... .../Certifications Certified Fraud Investigator preferred. Pay...FraudFull timePart timeWork at officeRemote workFlexible hours- The Ncaocr in Wake County, NC, is hiring a Financial Investigator to support investigations into Medicaid fraud and patient abuse. Responsibilities include conducting interviews, analyzing financial documents, and preparing investigative reports based on findings. Candidates...FraudWork at office
- Ncaocr is seeking a Special Agent to conduct investigations into suspected workers' compensation fraud across North Carolina. This field-based role requires expertise in law enforcement and criminal investigation, focusing on identifying and deterring violations. The ideal...Fraud
- Plaid Inc in Raleigh, North Carolina, is seeking a Senior Fraud and Abuse Operations Analyst to safeguard the platform against fraud and abuse. You will investigate incidents and collaborate with product teams to mitigate risks and enhance security. The ideal candidate...SeniorFraud
- ...drives us Ethos Risk Services is continuing to expand our team of Private Field Surveillance Investigators ! We are looking for Experienced Licensed Investigators to investigate fraud and conduct covert surveillance in the field (from your vehicle). Ethos Risk is one of...FraudLocal areaRemote workWeekend work
EmergencyMD
Raleigh, NC4 days ago $51.08k
...Investigator Charlotte Do you love getting to the bottom of things? Do you have a track record of conducting successful investigations... ...compromise the organization's integrity, including theft and fraud committed against the Lottery, its vendors, players, and retailers...FraudCasual workFlexible hoursNight shiftWeekend workNC Education Lottery
Raleigh, NC7 days ago$55.22k
...Specialist at the Office of Victim Compensation Services.This position investigates compensation claims for approval of payment as outlined in... ...Compensation fund to verify legitimacy of claims, detect fraud, and verify submitted law enforcement information.Maintain an...FraudFull timePart timeWork experience placementInternshipWork at officeLocal areaRemote workMonday to FridayNorth Carolina Department of Public Safety
Raleigh, NC4 days ago$85k - $95k
...that result in good government reforms. OSA thoroughly investigates alleged cases of fraud, waste, and abuse of taxpayer dollars, working with law enforcement on... ...) is seeking an Investigative Analyst to assist the Special Investigations Division by receiving, entering,...FraudFull timeWork at officeLocal areaVisa sponsorshipFlexible hours- ...Income Maintenance Investigator II Johnston County Department of Social Services has an immediate... ...working independently in investigation fraud or alleged fraud cases in the income... ...fraud, misrepresentation, or program abuse. This position must have thorough knowledge...FraudWork at officeImmediate start
Johnston County Government
Knightdale, NC1 day ago - Centene Corporation is seeking a skilled Investigator to lead complex internal investigations and ensure compliance with laws and regulations. This role involves evaluating allegations, conducting interviews, and managing investigation strategies. The ideal candidate will...SeniorRemote jobFlexible hours
- NATIONAL INVESTIGATIVE TRAINING ACADEMY INCORPORAT is seeking an experienced surveillance investigator in Charlotte, NC. The role requires a current private investigation license, reliable transportation, and a clean criminal record. This position offers both full-time...SeniorFull timePart time
- Humana Inc is seeking an experienced Dentist for their Dental Fraud and Waste Lead role. This position involves conducting clinical... ...strong communication skills, and have both clinical and investigative experience. Benefits include 401k match, paid time off, and tuition...FraudRemote job
- A leading pharmaceutical company in Raleigh, NC seeks an experienced Investigator - Exceptions / OOS Writer to lead and author investigations in a regulated environment. This role involves root cause analysis, ensuring compliance with cGMP, and collaborating cross-functionally...Senior
- ...seeking a Principal Specialist-Employee Relations to support the centralized Employee Relations function. You will lead sensitive investigations, provide guidance on corrective actions, and coach ER specialists for improved service quality. The ideal candidate will...Senior
MAXIMUS
Raleigh, NC18 hours ago - Practical Adult Insights is seeking an Insurance Fraud Investigator in North Carolina to evaluate insurance claims and verify their authenticity. This position entails collecting information about claimants, conducting surveillance, and documenting findings clearly. The...Fraud
$60k
What does an Insurance Fraud Investigator do? An insurance fraud investigator works for an insurance company to determine whether a claim is made under false pretenses. This role is especially important in disability claims, where evidence of limited movement or quality...FraudRemote work- A financial institution in North Carolina is seeking a Fraud Manager responsible for overseeing fraud prevention and detection operations... ...The ideal candidate will manage a fraud team, handle complex investigations, and collaborate with various stakeholders to minimize fraud...Fraud
$63.93k - $111.87k
...include Administration, Health Services, Rehabilitation & Reentry, Special Operations and the Post-Release Supervision & Parole Commission. We have a mission that matters!Description of WorkThe EEO Investigator supports the Department of Adult Correction by conducting...Work experience placementWork at officeTrial periodNight shiftState of North Carolina
Raleigh, NC19 hours ago- Apple Inc. is seeking an SDS Fraud Investigator for their Apple Store Online based in Cary, NC. The role involves analyzing orders to prevent fraudulent activity and ensuring a positive customer experience. In this position, you will work independently, interact with customers...Fraud
- The State of North Carolina - Office of the State Auditor is hiring an Investigative Analyst to assist with complaints regarding government waste and fraud. This full-time role involves conducting investigations, gathering information, and documenting findings. Qualified...FraudFull timeWork at officeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Investigator, Fraud & Abuse — Special Investigations. Be the first to apply!
Related searches
- insurance investigator Raleigh, NC
- remote investigator Raleigh, NC
- human rights investigator Raleigh, NC
- senior investigator Raleigh, NC
- case investigator Raleigh, NC
- corporate security investigator Raleigh, NC
- federal investigator Raleigh, NC
- housing investigator Raleigh, NC
- research investigator Raleigh, NC
- aml investigator Raleigh, NC