Fraud Investigator
Virtual Vocations Inc
Conducting comprehensive fraud, waste, and abuse investigations, the full-time SIU Investigator will analyze claims data, medical records, and provider information while collaborating with stakeholders to support case resolution in a remote setting. Key responsibilities Conducts investigations utilizing various resources to identify potential misconduct and support case resolution Prepares investigative reports, case summaries, and referrals for internal and external stakeholders Collaborates with compliance, legal, and provider teams to coordinate investigative activities and support corrective actions Required qualifications Bachelor's Degree in Business, Criminal Justice, Healthcare, or a related field, or equivalent experience 5+ years of experience in healthcare fraud, waste, and abuse investigations or insurance claims investigations Experience analyzing healthcare claims, medical records, and billing documentation preferred Virtual Vocations Inc
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Fraud Investigator in New York, NY vacancy
- ...Responsibilities Responsible for operating the Fraud & Abuse hotline involving the intake of all complaints and entry into the Department’s case tracking database. Conduct confidential investigations of all assigned cases: collect support evidence, data analysis, identify...SuggestedWork at office
Taleo
New York, NY1 day ago $77.1k - $92.52k
...Investigator PositionThe Investigator will be responsible for triaging, investigating and resolving instances of healthcare waste and billing errors conducted by the medical profession, insured members or the broker community. You will be utilizing information from claims...SuggestedMJHS
New York, NY1 day ago- ...Summary Statement This is experienced level investigation work of alleged or probable violations of state or federal laws, rules and regulations. In addition to work performed by an Investigator I, employees independently perform the full range of Essential Functions under...Suggested
delaware
New York, NY2 days ago $77.1k - $92.52k
...Forgiveness Program (PSLF) Responsibilities: The Investigator will be responsible for triaging, investigating and resolving... ...degree. ~1 + years of experience in health care fraud, waste and abuse investigations. ~ Certified Coding Specialist...SuggestedFull timePart timeWork at officeFlexible hoursMJHS
New York, NY1 day ago- Job Overview We’re hiring a Fraud Prevention Analyst to identify, analyze, and prevent fraudulent activity across customer accounts and transactions. You’ll monitor high‑risk patterns, investigate suspicious behavior, and help strengthen fraud controls. Responsibilities...Suggested
$22.65 per hour
About the Role: Fraud Analysts are responsible for reviewing user activity, identifying fraudulent behavior, and ensuring accurate, fair outcomes. This is an execution-focused role centered on consistent, high-quality review work within established guidelines. Success in...Hourly payFull timeMonday to FridayWeekend workDay shift$66.96k
...Office of the New York State Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) seeks forensic accountants/auditors (FAA)... ...and legal support analysts to conduct complex healthcare fraud investigations. The Medicaid program provides health coverage to millions of...Work experience placementWork at officeLocal areaRemote workFlexible hoursOffice of the New York State Attorney General
New York, NY4 days ago$70k - $85k
...We are currently seeking an entry‑level Staff candidate with up to two years of public accounting experience to work within our Investigative Accounting Group. We offer a flexible, hybrid work environment. The majority of our engagements involve working with commercial...Work experience placementLocal areaFlexible hoursNight shiftMeaden & Moore
New York, NY1 day ago- ...experienced professional to join our Risk team that will support fraud. This is an exciting opportunity to join a rapidly growing... ...and analyze strategies, models, and systems to detect, prevent, investigate, and mitigate the effects of fraud What We’re Looking For: 2+ years...
$70k - $105k
...impact from day one. About the Role Family banking has a distinct fraud profile. Minor cardholders face unauthorized transactions they... ...lifecycle transaction monitoring, and suspicious activity investigation, reporting directly to the Head of Compliance. This is a hands...H1bRemote workVisa sponsorshipWork visaFlexible hours- ...Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete...Full timeWork experience placementWork at officeLocal area
CGS Federal (Contact Government Services)
New York, NY3 days ago - A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing claims data, and preparing reports. A bachelor's degree and 1+ years in medical claim analysis are essential. Preferred candidates...Remote work
Centene Corporation
New York, NY4 days ago - ...CVS Health is seeking a Senior Investigator for the Aetna Special Investigations Unit. The role focuses on complex national healthcare fraud investigations across multiple lines of business, including Medicaid-related matters. You will conduct research, perform data mining...
CVS Health
New York, NY4 days ago - To shape fraud strategy as the company scales, the full-time Senior Fraud Analyst will manage fraud controls across payment products, identify emerging threats, and collaborate with cross-functional teams in a hybrid work environment. Key responsibilities Own and evolve...Full time
- Forensic Accountant / Business Interruption Specialist Location: New York A leading global forensic accounting firm is seeking an experienced Forensic Accountant / Business Interruption Specialist to join its New York office. This is an excellent opportunity to work on...
$66.3k - $75.33k
Municipal Credit Union, based in New York, seeks a Fraud Analyst to prevent losses and support investigations within Financial Crimes & Intelligence. You will analyze alerts from fraud detection systems, assess risk, compile investigations, and ensure compliance with BSA...Remote job$90k - $142k
...Supervisor - Litigation will oversee forensic accounting and litigation support engagements, providing expertise in financial fraud investigations, damage calculations, and dispute resolution. The role involves working closely with attorneys, clients, and internal teams...Full time$85k - $110k
...currently seeking a career-minded Senior Forensic Accountant with two to five years of public accounting experience to work within our Investigative Accounting Group. We offer a flexible, hybrid work environment The majority of our engagements involve working with...Work experience placementLocal areaFlexible hoursNight shiftMeaden & Moore
New York, NYa month ago$116k - $203k
...The Role We’re looking for a Lead Fraud Intelligence & Strategy Analyst to join our team at Verafin. Reporting to an AVP of Product... ...’ll fit right in if you’re naturally curious, analytical, and investigative, and you love digging into data to understand not only what is...Full timeTemporary workWork at officeHome officeFlexible hours3 days per week$70k - $75k
...entry-level Forensic Accountant to assist our Senior Forensic Accountants in conducting forensic audits and investigations, corporate compliance programs, fraud examinations, construction monitoring and litigation support matters. Responsibilities will include assisting...Full timeBank staffWork at officeMonday to FridayNight shiftWeekend work- Focused on protecting the integrity and profitability of financial products, the full-time remote Fraud Investigator II will execute fraud and risk operations, conduct investigations into suspicious activities, and develop scalable fraud controls across the customer lifecycle...Full timeRemote workShift work
- ...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...
EmblemHealth
New York, NY2 days ago - Partnering with enterprise customers, the remote Fraud Strategist will serve as a subject matter expert in fraud and identity, focusing on designing optimal product implementation strategies, evaluating risk profiles, and driving efficient customer onboarding and rollout...Remote work
- ...Consultant, a rising star in the consulting and/or Big Four space that is interested in working on complex commercial dispute and investigations matters with some of our top experts. Key Responsiblities Develop and maintain electronic databases, spreadsheets and...Work at officeNew York, NY11 days ago
- MaziCTools is seeking candidates for a full-time role focused on fraud investigations and analytics. The position involves engaging with engineering teams and non-technical stakeholders to enhance workflows. Ideal candidates will have a Bachelor's degree in a technical...Full timeWeekend work
- MaziCTools is looking for a Full-time Fraud and Chargeback Analyst, responsible for identifying fraudulent activities and optimizing chargeback processes. This position allows for a remote-first approach and embraces a collaborative and diverse culture. The ideal candidate...Remote jobFull time
$26 - $33 per hour
...Description Command Investigations LLC is seeking an Insurance Claims Investigator with a minimum of one year of experience to become part of a dynamic team. This is a great opportunity for individuals with prior claims investigation experience who demonstrate integrity...Hourly payFull timeSecond jobWork at officeRemote workFlexible hoursNight shiftCommand Investigations
New York, NY4 days ago- ...ideas and impact the roadmap and vision of our company. The fraud risk management team at Rain creates sophisticated, scalable... ...and customers. Create ad hoc data pulls with SQL for anomaly investigation and analyze the results for fraudulent activity. Document...Work at officeWork from homeWorldwideWork visaFlexible hours
- ...impact the roadmap and vision of our company. About the Team The fraud risk management team at Rain creates sophisticated, scalable... ...and customers. Create ad hoc data pulls with SQL for anomaly investigation and analyze the results for fraudulent activity. Document...Work at officeWork from homeWork visaFlexible hours
- Working remotely, the full-time hourly Fraud Operations Analyst will monitor real-time transactions for fraudulent behavior, investigate flagged activities, and collaborate with cross-functional teams to enhance fraud prevention mechanisms. Key responsibilities Monitor...Hourly payFull timeRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Fraud Investigator. Be the first to apply!
Related searches
- bank fraud investigator New York, NY
- fraud investigator New York, NY
- fraud manager New York, NY
- fraud prevention New York, NY
- anti fraud New York, NY
- fraud specialist New York, NY
- fraud officer New York, NY
- fraud consultant New York, NY
- fraud prevention manager New York, NY
- work from home fraud jobs New York, NY