UNKNOWN

FEED

Minimum Requirements: Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or any combination of education and experience, which would provide an equivalent background. Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.

Elevance Health Inc

Clinical Fraud Investigator II

This Senior Fraud Investigator is responsible for detecting, investigating, and resolving suspected internal and external fraudulent activity, including check fraud, ACH fraud, wire fraud, account takeover incidents, elder exploitation, and other financial crimes reported by customers or identified through internal monitoring systems. * Investigate suspected fraudulent transactions including more complex incidents of Employee fraud, fraud rings, check fraud, wire fraud, ACH fraud, debit/credit card fraud, identity theft, elder financial abuse, account takeover, and synthetic identity fraud.

Northwest Bank

Senior Fraud Investigator

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Pursuant to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must file an Annual Statement of Financial Disclosure (FDS) with the NYS Commission on Ethics and Lobbying in Government (the "Commission"). As an employee of MTA NYC Transit, you may be required to complete an annual financial disclosure statement with the state of New York, if your position earns more than $101,379 (this is subject to change) per year or if the position is designated as a policy maker.

YEAR

Metro is unique among the nation’s transportation agencies. We serve as transportation planner and coordinator, designer, builder, and operator for the country’s largest, most populous county. More than 10 million people – nearly one-fourth of California’s residents – live, work and play within our 1,433-square-mile service area.

Metropolitan Transportation Authority

Claims Fraud Investigator

Designed with our employees needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. Our hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused work from a preferred location, while still supporting meaningful in-person collaboration when it adds value.

Zurich Insurance Group Ltd

Working Conditions: Conditions involve lifting no more than ten pounds, sitting most of the time, but may involve walking, moving, or standing for brief periods, and occasionally lifting and carrying articles like files, ledgers, folders, etc. Resource Champions are available to connect you to comprehensive services including expert banking, wealth planning, ESOP, health & wellness programs, impactful community involvement & financial literacy education.

Woodforest National Bank

Fraud Investigator I

Associate or bachelor's degree in criminal justice or related field, OR five years of insurance claims investigation experience, OR professional investigation experience with law enforcement agencies, OR seven years of professional investigation experience involving economic or insurance related matters. Verify receipts, complete activity checks, and other investigative processes with SIU resource materials such as cameras, computers, and recorders.

NYCM Insurance

Fraud Investigator (Hybrid)

This includes data mining for potential intakes, performing preliminary analysis on provider cases, and working on projects focused on preventing, detecting, and correcting fraud, waste, and abuse. In this position, you will assist the Director of Controls and Compliance and the Special Investigative Unit Manager in conducting investigations into suspected incidents of Fraud, Waste, and Abuse (FWA).

Texas Children's Hospital

Senior SIU (Claims Fraud) Investigator

Beyond individual casework, you’ll serve as a trusted fraud resource, share investigative best practices, support employee training, and help identify proactive responses to new or evolving fraud trends. As a Fraud Investigator II at Truliant Federal Credit Union, you’ll lead complex investigations that help protect our members, reduce losses, support recovery efforts, and strengthen how we respond to evolving financial crime.

Truliant Federal Credit Union is a mission-driven, not-for-profit financial institution that promises to always have its member-owners’ best interest at heart by improving their lives through providing financial guidance and affordable financial services. Truliant was chartered in 1952 and now serves more than 200,000+ members and currently has 31 Member Financial Centers in North Carolina, South Carolina and Virginia. For more information on Truliant Federal Credit Union, visit www.truliant.org.
Our mission is to enhance the quality of life of our members and become their preferred financial institution.

Truliant Federal Credit Union

Fraud Investigator II

Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or any combination of education and experience, which would provide an equivalent background. Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.

Elevance Health

The Metropolitan Transportation Authority is North America's largest transportation network, serving a population of 15.3 million people across a 5,000-square-mile travel area surrounding New York City, Long Island, southeastern New York State, and Connecticut. Pursuant to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must file an Annual Statement of Financial Disclosure (FDS) with the NYS Commission on Ethics and Lobbying in Government (the "Commission").

Supervising Claims Fraud Investigator

Utilize clients fraud detection solution to identify post-payment or pre-payment opportunities for investigation as well as other applications to perform data mining or track investigative results. Integrity Advantage is a small woman owned business serving health payers and other entities challenged with the detection, investigation and prevention of healthcare fraud, waste and abuse (FWA).

HireAligned

Healthcare Fraud Investigator at Integrity Advantage (Remote)

dstribute

This Senior Fraud Investigator is responsible for detecting, investigating, and resolving suspected internal and external fraudulent activity, including check fraud, ACH fraud, wire fraud, account takeover incidents, elder exploitation, and other financial crimes reported by customers or identified through internal monitoring systems. Investigate suspected fraudulent transactions including more complex incidents of Employee fraud, fraud rings, check fraud, wire fraud, ACH fraud, debit/credit card fraud, identity theft, elder financial abuse, account takeover, and synthetic identity fraud.

The right direction can take you places in life. 
 The right bank can be your compass &mdash; especially when you look Northwest to discover a 115-year-old community bank with 167 locations in four states.
 A bank where people really do make the difference. 
 At Northwest Savings Bank, we are local bankers making local decisions, committed to the communities we serve, and dedicated to the satisfaction and success of our friends and neighbors. 
 Every day, Northwest Savings Bank can take you where you want to go with best in class products and services for you and your business &mdash; including checking, Online banking, online bill pay, over 43,000 ATMs, and so much more. 
 Wherever you’re going in life &mdash; a dream home, a college education for the kids, a comfortable retirement, or just a better future &mdash; Northwest can take you there.

Northwest Bancorp, Inc.

2+ years of fraud investigation experience involving multiple fraud typologies, including Account Takeover (ATO), Identity Theft, scams, and related fraud schemes, with demonstrated proficiency using fraud detection platforms and analytical tools to identify, investigate, and mitigate fraudulent activity. 2+ years of experience conducting fraud investigations across a variety of banking products and services, including checking and savings accounts, credit cards, loans, and other consumer banking products, with the ability to identify, investigate, and resolve complex fraud-related concerns.

National Bank of Arizona

Fraud Investigator - Midvale, UT or Phoenix, AZ (In-Office)

Working Conditions: Conditions involve lifting no more than ten pounds, sitting most of the time, but may involve walking, moving, or standing for brief periods, and occasionally lifting and carrying articles like files, ledgers, folders, etc. Builds cases to substantiate allegations of fraudulent activity by requesting and compiling witness statements and evidence from employees and/or customers that were involved in transactions that resulted in a potential loss.

Woodforest Bank

You'll contribute to the bank's overall strategy and risk profile by: Conducting comprehensive alert and case investigations which includes analyzing transaction information, reviewing customer data, researching open source and media checks, recommending alerts moving to case or no case, and a SAR or no SAR to be filed. As a FEA External Fraud Investigator, you will conduct enterprise-wide investigations identifying unusual activity and preparing Suspicious Activity Reports (SARs) to be filed with Financial Crimes Enforcement Network (FinCEN) as well as writing and preparing cases that result in No SARs.

U.S. Bancorp

FEA External Fraud Investigator

Communicate professionally with customers, financial institutions, and other Bank personnel to resolve problems or request additional information and/or documentation to support a decision on whether fraudulent activity has occurred. Fraud Investigator also works closely with Customer Success and Deposit Operations (re: Chargebacks, Disputes, and New Accounts), as well as Compliance officers and all other internal teams to mitigate risk.

Live Oak Bank

Fraud Investigator

Review and disposition fraud alerts in VerafinReview, respond and disposition fraud alerts related to online banking activity, mobile/ATM deposits, elder financial exploitationIntake branch and business line referrals for fraudulent situations involving consumer, online banking, business and wealth management customersFraud case management, including case entry to Verafin, filing of Suspicious Activity Reports (SARs) and photo requests from law enforcementProduction and filing of referrals and criminal complaints for complex fraud casesCustomer contact/conversations regarding fraud situations and interaction with peer bank and law enforcement contactsReview surveillance video in the course of investigationsRepresent the Bank in professional fraud associationsDevelopment and presentation of internal fraud trainingDevelopment and presentation of external facing fraud awareness materialWork with Marketing to create and execute strategies for fraud awareness material. Represent Corporate Security in risk assessment activities to support front line functions related to new initiatives and changes to existing processesWork with Operations, Risk Management, Technology, Information Security, Compliance and Financial Administration to define processes and policies to support products and servicesRobbery response (surveillance review, physically respond to branch location, communication with internal and external stakeholders)Production of metrics for fraud alert and case management activities.

Washington Trust Bancorp, Inc.

Bank Fraud Investigator

Performs case research to include the review, interpretation, and application of payment policies, medical policies, provider manuals, benefits documents, national or local coverage determinations, and other applicable clinical practice parameters, regulations, or guidance pertaining to the submission of claims to health insurance plans. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

Mass General Brigham

SIU Fraud Investigator

Construct enterprise fraud scenarios for large-scale transaction monitoring, multi-stakeholder investigation workflows, and complex regulatory reporting cycles at Fortune 500 institutions. Develop fraud operations scenarios using tools like SAS Fraud Management , Actimize , Feedzai , and enterprise case management/transaction monitoring platforms.

HOUR

Mercor

Fraud Investigator - Fully Remote

Manatal

Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. Our hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused work from a preferred location, while still supporting meaningful in-person collaboration when it adds value.

Research Investigator Jobs in the United States

Clinical Fraud Investigator II Elevance Health Inc

Senior Fraud Investigator Northwest Bank

Claims Fraud Investigator Metropolitan Transportation Authority

Claims Fraud Investigator Zurich Insurance Group Ltd

Fraud Investigator I Woodforest National Bank

Fraud Investigator (Hybrid) NYCM Insurance

Senior SIU (Claims Fraud) Investigator Texas Children's Hospital

Fraud Investigator II Truliant Federal Credit Union

Clinical Fraud Investigator II Elevance Health

Supervising Claims Fraud Investigator Metropolitan Transportation Authority

Healthcare Fraud Investigator at Integrity Advantage (Remote) HireAligned

Senior Fraud Investigator Northwest Bancorp, Inc.

Fraud Investigator - Midvale, UT or Phoenix, AZ (In-Office) National Bank of Arizona

Fraud Investigator I Woodforest Bank

FEA External Fraud Investigator U.S. Bancorp

Fraud Investigator Live Oak Bank

Bank Fraud Investigator Washington Trust Bancorp, Inc.

SIU Fraud Investigator Mass General Brigham

Fraud Investigator - Fully Remote Mercor

Claims Fraud Investigator Zurich Insurance Company Ltd.

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