Fraud Investigator

1 week ago

Rancho Cucamonga, United States JobTracks Full time

About the RoleAs a Fraud Investigator 1, you will help protect the Credit Union and its members by investigating fraudulent activities, preventing losses, and ensuring compliance with regulations.Key Responsibilities Fraud Investigation & Prevention Investigate fraud cases, unauthorized transactions, and suspicious activity. Communicate with members, financial institutions, and internal teams to resolve fraud claims. Monitor accounts, online activity, and reports to detect and prevent fraud. Track and report elder abuse or high-risk transactions. Take action to recover funds and prevent further losses. Member Support Assist members impacted by fraud via phone, email, and secure messages. Provide clear, professional, and timely communication. Maintain confidentiality while handling fraud cases. Compliance & Risk Management Ensure compliance with banking regulations (BSA, AML, OFAC, USA Patriot Act). Stay updated on industry fraud trends and best practices. Maintain accurate case records and escalate issues when necessary. What We're Looking For Strong attention to detail and analytical skills. Ability to multitask and prioritize in a fast-paced environment. Experience in fraud investigations, banking, or a related field is a plus. Excellent communication and problem-solving skills. This role is essential in protecting our members and the Credit Union from fraud. If you have a keen eye for detecting suspicious activity and a passion for risk prevention, we'd love to hear from you

  • Special Investigations Unit

    1 week ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    OverviewWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!The Special Investigations Unit Investigator II investigates and analyzes incidents of suspected fraud, waste, and abuse in accordance with regulatory...

  • Lead Investigator, Special Investigations Unit

    4 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    The Lead Investigator - Special Investigations Unit (SIU) (Lead Investigator) is responsible for investigating and resolving high complexity allegations of healthcare Fraud, Waste and Abuse (FWA) by medical professional, facilities, and members. This position researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in...

  • Lead Investigator, Special Investigative Unit-(kentucky)

    2 weeks ago

    Rio Rancho, United States New Mexico Staffing Full time

    Job SummaryUnder direct supervision of the Manager, SIU, the Team Lead is responsible to lead a small team of investigators and provide oversight on daily investigative activities as a back-up to the SIU Manager. This position will be accountable for tracking on investigations conducted by his/her team and will provide oversight and guidance throughout the...

  • Special Investigations Unit Medical Reviewer

    2 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time $71,573 - $93,038

    OverviewWhat you can expect  Find joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experienceUnder general supervision, the Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and healthcare claims...

  • SIU Intelligence Analyst

    1 week ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    OverviewWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!The Special Investigations Unit (SIU) Intelligence Analyst is responsible for providing proactive, data-driven intelligence to prevent and detect healthcare...

  • SIU Intelligence Analyst

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Special Investigations Unit (SIU) Intelligence Analyst is responsible for providing proactive, data-driven intelligence to prevent and detect healthcare...

  • Forensic Accounting Director

    4 weeks ago

    Rancho Cucamonga, United States National Associates Of Certified Valuati Full time

    Forensic Accounting DirectorLocation: California, Nevada, or UtahWork Arrangement: In office, Hybrid, or RemoteTypical Day in the LifeA typical day as a Forensic Accounting Director might include the following:Assist with developing opportunities to grow our Fraud & Forensic Advisory practice by identifying referral relationships with law firms and...

  • Inside Claim Adjuster

    4 weeks ago

    Rancho Cordova, United States Travelers Full time

    Claims Handler This position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution/settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear...

  • Workers Comp Claims Oversight Specialist

    4 weeks ago

    Rancho Cordova, United States Samuel Hale Full time

    Join Our Dynamic Team as a Workers' Comp Claims Oversight Specialist!Position: Claims Oversight SpecialistLocation: In-Office, Rancho Cordova, CA 95670Job Type: Full-time ExemptSalary: $71,000 – $95,000Who We Are: EmployInsure LLC delivers Engineered Employment Products designed to eliminate gaps from antiquated practices and enable Frictionless Employment...

  • Inside Claim Adjuster

    4 weeks ago

    Rancho Cordova, United States Travelers Full time

    Claims HandlerThis position is responsible for handling low to moderate Personal and Business Insurance Auto Damage claims from the first notice of loss through resolution/settlement and payment process. This may include applying laws and statutes for multiple state jurisdictions. Claim types include multi-vehicle (2 or more cars) auto damage with unclear...