Insurance Fraud Investigator

Job SummaryWe are seeking a highly skilled and experienced Senior Fraud, Waste, and Abuse Specialist to join our team at Sharp HealthCare. This critical role involves overseeing the entire lifecycle of fraud, waste, and abuse investigations, ensuring compliance with regulatory, accreditation, and contract standards.Key ResponsibilitiesTriage and investigate...

Job SummarySharp HealthCare is seeking a highly skilled Senior Fraud, Waste, and Abuse Specialist to join our team. As a critical member of our compliance department, you will be responsible for overseeing the entire lifecycle of fraud, waste, and abuse investigations.Key ResponsibilitiesTriage and investigate allegations of fraud, waste, and abuse, ensuring...

Job Title: Investigator - Fraud Detection SpecialistAbout the Role:The Department of Health Care Services is seeking a skilled Investigator to conduct thorough and complete investigations into allegations of fraud perpetrated against the California Medical Assistance Program (Medi-Cal) and other programs under the department's review.Key...

Job Summary:The Department of Health Care Services (DHCS) is seeking a skilled Investigator to conduct thorough and complete criminal/civil investigations into allegations of fraud perpetrated against the California Medical Assistance Program (Medi-Cal) and other programs under the review of the Department.About the Role:The Investigator will be responsible...

About this Role:The Department of Health Care Services (DHCS) is seeking a skilled Investigator to conduct thorough and complete investigations into allegations of fraud perpetrated against the California Medical Assistance Program (Medi-Cal) and other programs under the department's review.Key Responsibilities:Conduct field-based investigations, utilizing a...

Job Description and DutiesAre you interested in fighting healthcare fraud using your analytical and quantitative skills? Does helping recover stolen funds from the Medi-Cal program and protect our elderly from financial abuse sound intriguing? The Division of Medi-Cal Fraud and Elder Abuse Investigation section is looking for talented investigative auditors...

Fraud and Security AgentWe are seeking a detail-oriented and analytical Fraud and Security Agent to monitor, detect, and prevent fraudulent activities in customer transactions while ensuring a secure environment for our clients.Key Responsibilities:Monitor transactions for signs of suspicious or fraudulent activity.Respond to customer inquiries regarding...

Job OverviewAs a Loss Prevention Investigator at Neiman Marcus, you will play a critical role in preventing losses from external and internal theft and fraud. You will work closely with the Loss Prevention team to identify and investigate incidents, and develop strategies to prevent future losses.Key Responsibilities• Maintain the general safety of...

Job OpportunityNeiman Marcus Group is a relationship-driven business that leads with love in everything we do. Our legacy of innovating and our culture of Belonging guide our roadmap for Revolutionizing Luxury Experiences. Our brands include Neiman Marcus and Bergdorf Goodman.Your RoleAs a Loss Prevention Investigator, you will work as a member of our Loss...

Job DescriptionAt Ethos Risk Services, we are seeking a skilled Private Field Surveillance Investigator to join our team. As a Surveillance Investigator, you will conduct covert surveillance, review files, and draft detailed case reports. Working autonomously from your vehicle, you will capture video evidence of surveillance targets, collaborate with our...

Job SummaryWe are seeking a highly skilled Compliance Investigator to join our team at San Francisco Health Plan. As a Compliance Investigator, you will play a critical role in supporting our Compliance Program through audit, investigation, and monitoring activities.Key ResponsibilitiesConduct thorough and unbiased investigations into allegations of fraud,...

Job SummaryWe are seeking a highly skilled Compliance Investigator to join our team at San Francisco Health Plan. As a key member of our Compliance Program, you will play a critical role in ensuring the integrity of our operations and maintaining compliance with regulatory requirements.Key ResponsibilitiesConduct thorough investigations into allegations of...

Job Description and DutiesThis position is being re-advertised to increase the candidate pool. If you have previously applied, you do not need to reapply.Position located in the Health Quality Investigation Unit (HQIU) San Diego Field Office.Please refer to duty statement.This recruitment is until filled and applications will be reviewed on a monthly basis....

Job SummaryWe are seeking a skilled Insurance Claims Examiner to join our team at Progressive Insurance. As a Claims Adjuster, you will be responsible for managing claims, including the injury portion, and ensuring a swift resolution.Key ResponsibilitiesMaking coverage decisions that determine the extent of Progressive's liabilityGathering details through...

Job Title: SIU Field Investigator Senior Consultant IThis role is responsible for conducting thorough investigations and analyzing complex claims to identify potential fraud. The ideal candidate will have a strong analytical mind, excellent communication skills, and the ability to work independently.Key Responsibilities:Conduct background searches, scene...

Job SummaryWe are seeking a highly skilled and motivated Investigator to join our team at the District Attorney's Office. As an Investigator, you will play a critical role in the detection and investigation of all criminal matters submitted to our office.Key ResponsibilitiesInvestigate suspected welfare fraud, child abduction, officer involved shootings,...

Job OverviewAt Allied Universal Compliance and Investigations, we're seeking a skilled Surveillance Investigator to join our team. As a Surveillance Investigator, you'll play a critical role in conducting discreet mobile and stationary surveillance of claimants to confirm their current activities and capabilities. This position offers a unique opportunity to...

About the RoleWe are seeking a seasoned fraud expert to lead our charge card fraud prevention efforts at Atlas, Inc. Defunct. As Head of Fraud, you will be responsible for developing and implementing our overarching fraud and risk strategy to mitigate fraud loss for our new flagship charge card product.Key ResponsibilitiesDevelop and maintain a deep...

Job SummaryThis position is responsible for supervising a team of investigators in the Department of Consumer Affairs. The incumbent will conduct complex and sensitive investigations, supervise staff, and ensure compliance with regulations and policies.Key ResponsibilitiesSupervise a team of investigators in conducting investigations and gathering...

Claims Resolution ExpertThis position is available in various locations across California, including Riverside, Irvine, San Diego, Pasadena, Torrance, Thousand Oaks, Sherman Oaks, Fresno, Modesto, Sacramento, and Concord.As a Claims Resolution Expert, you'll independently manage claims, including the injury portion, while supporting customer needs and...