Fraud investigator jobs near me - 92 jobs

The Clinical Investigator monitors service delivery for program integrity through fraud and abuse investigations and audits, including review of claims data, clinical records and reference materials, investigative interviewing, provider education and technical assistance, and monitoring implementation of provider corrective actions. The Investigator reports overpayments and other irregularities and confers with Special Investigations Unit, Senior Management, Chief Compliance Officer and General Counsel as needed. This position will allow the successful candidate to work primarily remote schedule. The candidate must be a resident of North Carolina or reside within 40 miles radius of North Carolina's border. There is no expectation of being in the office routinely, however, the selected candidate will be required to travel to provider sites to conduct audits/investigations in Charlotte, North Carolina up to 3 times per month. Responsibilities & Duties Conduct Audit/Investigations and prepare reports Review allegation(s), conduct preliminary investigation and make disposition recommendations using independent judgment Develop audit/investigation plans and tools based upon alleged non-compliance and data analytics Request and/or collect medical records, personnel records, policies/procedures, compliance plans, and other documents from providers based on audit/investigation plans Systematically and accurately collect, document, and store evidence Conduct post-payment audits of Medicaid and State funded providers to ensure that services are rendered in accordance with established state and federal rules, regulations, policies, and terms of provider contractual agreements with the state Identify inappropriate billing and overpayments Utilize clinical knowledge and experience to determine if documented services were clinically appropriate and/or medically necessary Conduct interviews with provider employees, former employees, recipients of services, and other witnesses Document allegations, investigative activities, and findings in a detailed audit/investigation report Work with the Special Investigations Supervisor and Investigative Team to support investigative activities Assure that individuals served do not pay for health services inappropriately Track allegations of fraud, waste, and abuse in a case management system from referral to final disposition Consult with the Corporate Compliance Unit when potential internal compliance issues are identified Consult on cases Provide clinical guidance to non-clinical staff on documentation obtained from providers Provide guidance to non-clinical staff on Medicaid Clinical Coverage Policies and State Service Definitions and by participating in ad hoc meetings related to clinical regulatory matters Participate in ad hoc meetings related to clinical matters Conduct Regulatory Review/ Research Diligently research clinical policies, administrative code, federal/state laws in order to assess for non-compliance Analyze data Analyze data from a variety of sources, including but not limited to claims, authorizations, credentialing/enrollment, grievances, prior audits/investigations, incarceration records, incident reports, policies/procedures, to inform decision making Utilize various MicroStrategy reports data during the investigation process Analyze claims data to determine if an allegation is supported Analyze claims data during investigations to determine if there are indicators of fraud/abuse other than the allegation received Identify other data sources to review during investigations based on the allegation(s) Provide Case reports/presentations to internal and external stakeholders Present audit/investigation findings and make disposition recommendations using independent judgment to the Chief Compliance and Risk Officer, Senior Director of Program Integrity, Special Investigations Supervisor, and Alliance Compliance Committee Present case status updates in individual supervision sessions, unit team meetings, Division meetings (as designated by supervisor), and to NC Department of Justice (as requested) Conduct and participate in Investigation Planning meetings with the Investigation Team Interpret and convey highly technical information to others Provide Technical Assistance/Education Educate providers on the errors identified in the audit and investigation process Recognize when providers can improve through technical assistance (TA) rather than full investigation when FWA is not evident and/or pervasive Recognize quality of care issues in order to make recommendations to appropriate entities/authorities Monitor Provider Action and Follow-Up Document Improper Payment Charts, Statements of Deficiency, provides feedback and technical assistance to providers as needed/requested, and follows up on provider corrective action through the probation process, as applicable Prepare for and participate in provider appeal process and/or court hearings to explain and defend audit/investigation findings Recommend policy, procedure, or process changes Recommends revisions to Alliance Health procedures and policies Minimum Requirements Education & Experience Graduation from an accredited school of Nursing with a Registered Nurse (RN) license and five (5) years relevant post-graduate experience. OR Master's degree in human services/social sciences, health care compliance, analytics, government/public administration, auditing, security management, criminal justice, or pre-law and Five (5) years relevant post-graduate experience. Special Requirement- Current, unencumbered clinical license as an LCSW, LCMHC, LMFT, LCAS, LPA or RN Preferred Health care industry and/or Medicare/Medicaid/Behavioral Health experience and knowledge SIU and/or regulatory compliance work experience National Certified Investigator and Inspector Training (NCIT) Basic and Specialized Knowledge, Skills, & Abilities Knowledge of Health care industry and/or Medicare/Medicaid/Behavioral Health Knowledge of the state and federal Medicaid laws, state and federal criminal and civil fraud laws, regulations, policies, rules, guidelines, service limitations, and various Medicaid programs Knowledge and proficiency in claims adjudication standards & procedures Knowledge of investigative methods and procedures High degree of integrity and confidentiality required handling information that is considered personal and confidential Skill in using Microsoft Office products (such as Word, Excel, Outlook, etc.) Analytical skills and ability to make deductions; logical and sequential thinker Strong verbal and written communication skills. Ability to write clear, accurate and concise rationale in support of findings Ability to manage time, prioritize work, and use problem-solving approaches Ability to interpret contractual agreements, business-oriented statistics medical/administrative services and records Ability to identify resources, gather evidence, analyze raw data and generate reports A general understanding of all major managed care functions in particular as it relates to prior authorization, utilization reviews, grievance management, provider credentialing and monitoring Knowledge of the Alliance Health service benefit plans and network providers Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Registration) check, which will be performed after acceptance of an offer of employment and prior to the employee's start date. Salary Range $77,868 - $99,282/Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

Job Description Nymbus (******************** is a high growth fintech company that enables financial institutions to transform their capabilities and drive value in today's digital finance world. At Nymbus, we believe when you set off on the path to innovation you should feel excitement and confidence, not fear and dread. With Nymbus we are bringing delight back into the banking process. We want our partners to be thrilled about the possibilities we are creating together and the lasting impact our collaboration will bring to the industry and consumers. The journey to growth begins with doing something different. And that journey starts with the great people that make Nymbus. Thank you for considering and entrusting Nymbus to be the catalyst that helps take your career through your next chapter. WORK ENVIRONMENT: We are a remote first company. This role, as most of our positions, is remote. You may be required at times to visit client sites or attend meetings at designated locations. POSITION SUMMARY: The Fraud Investigator plays a critical role in protecting the financial assets, operational integrity, and reputation of Nymbus clients by leading advanced investigations into complex and high-impact fraud cases across multiple payment channels and products. This role involves the proactive identification of suspicious patterns and anomalies through the review of transactional data, case alerts, and non-alert-based referrals from both internal and external sources. The Investigator will perform in-depth case analysis, connect cross-channel and cross-client fraud activity, and determine the root cause of fraudulent behavior. They will work directly with clients to present investigative findings, provide recommendations for risk mitigation, and ensure timely resolution of escalated cases. This includes preparing comprehensive reports, tracking key trends, and recommending targeted process enhancements. Collaboration is essential, as the Fraud Investigator partners closely with internal operations teams, external client contacts, and third-party fraud detection platforms to resolve cases efficiently and in compliance with regulatory standards. The role also involves drafting and maintaining investigative procedures, mentoring Fraud Analysts, and contributing to the development of enterprise-wide fraud prevention strategies. The ideal candidate will have proven expertise in fraud investigation, strong pattern-recognition skills, deep knowledge of financial regulations, and the ability to work effectively under pressure in a high-volume, deadline-driven environment. ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES: Include, but are not limited to: Lead end-to-end investigations into complex and high-impact fraud cases, ensuring timely and thorough resolution. Analyze transactional data across multiple sources to identify patterns, trends, and emerging fraud typologies. Develop and maintain detailed fraud reports for clients, highlighting findings, trends, and recommended actions. Collaborate with internal operational and support teams to ensure accurate documentation, escalation, and resolution of fraud incidents. Work with clients to provide investigative updates, final case reports, and recommended preventive measures. Conduct in-depth reviews of customer claims involving Debit card, Credit card, ACH, P2P, Bill Payments, and other payment channels, with a focus on complex and recurring cases. Identify gaps and recommend procedural enhancements to strengthen fraud prevention measures. Draft, update, and maintain fraud investigation procedures and best practices documentation. Serve as a subject matter expert for escalated fraud inquiries from Fraud Analysts and other team members. Track and report investigation metrics for client review. Stay current on industry fraud trends, regulatory changes, and compliance requirements to ensure investigative processes remain effective. Provide training and mentorship to Fraud Analysts on investigative techniques and case handling. QUALIFICATIONS: Associates degree in Business, Criminal Justice, Finance, or a related field preferred. Minimum 5 years of experience in fraud investigation or advanced fraud analysis, preferably in a financial institution or fintech environment. Proven track record managing complex investigations from initiation to resolution. Strong understanding of fraud detection tools and platforms (e.g., Verafin, DataVisor) and the ability to leverage multiple systems for analysis. Fraud certification (CFE, CFCI, or equivalent) strongly preferred. Expertise in identifying patterns, connecting data points, and recognizing emerging fraud trends. Strong understanding of banking operations, payment systems, and relevant regulations. Exceptional written and verbal communication skills, including the ability to prepare and deliver investigation reports to diverse audiences. Proven analytical, research, and problem-solving skills, with a detail-oriented mindset. Ability to work independently on complex assignments while collaborating effectively with cross-functional teams. Proficient in Microsoft Office and Google applications, with strong Excel and data analysis skills. Comfortable navigating multiple systems and applications in a fast-paced, deadline-driven environment. HOURS: Monday - Friday, 8:00 AM - 5:00 PM EST Rotating weekend coverage as scheduled Occasional flexibility may be required for urgent investigations or client needs. SALARY & BENEFITS: $65,000 - $75,000 Annual Salary Annual Cash Bonus and Equity Options commensurate with the role level and experience 100% Fully Remote Robust 401(k) plan with company match Insurance - Health, Dental and Vision (Nymbus covers 100% of the Healthcare and Basic Dental premiums) Flexible Paid Time Off Ready to join? We invite you to watch this video and learn who we are and how we build and innovates together! Let's Go!

llumifin provides third party administration and technology services to individual and group insurers. The company blends insurance industry knowledge, technology leadership and operational execution to prepare insurers for the digital future. illumifin is a diverse, passionate and empowered team of insurance specialists committed to the growth and success of its customers. With illumifin, there's a brighter future A SIU/Fraud Investigator is responsible for working with multiple business units on coordination, identification, mitigation, and reporting of incidents and risks related to anti-fraud activities. Conducts and/or assists with investigative tasks Reviews referrals of potential fraud, waste, and abuse from both auto-detection programs and from claims organization, as assigned Coordinates and performs investigations with oversight of lead investigator Prepares responses for suspected or alleged fraud Works closely with cross-functional leaders to ensure appropriate resolution, accurate reporting and tracking to meet client specific service level agreements Participates as a subject matter expert during client implementations, audits and system or process development Complies with state and federal laws to meet client contractual requirements Conducts effective research, analysis, and accurate documentation for reporting to clients and illumifin's leadership Schedules surveillance once approved by the client Conducts continuing education to Claims staff May conduct phone calls or basic interviews with witnesses, as assigned Assists with administration tasks relating to Fraud Services Department, as assigned Assists with client and department reporting Interfaces with claimants, providers and clients Conducts telephonic interviews of members, providers, and/or additional witnesses to gather information to support investigation Other duties as assigned

Healthcare Fraud Investigator 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 tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include:- Review, sort, and analyze data using computer software programs such as Microsoft Excel.- Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).- Develop HCF case referrals including, but not limited to:- Ensure that HCF referrals meet agency and USAO standards for litigation.- Analyze data for evidence of fraud, waste and abuse.- Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.- Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.- Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications:- Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.- Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.- Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.- Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).- Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.- Experience and expertise in performing the requisite services in Section 3.- Must be a US Citizen.- Must be able to obtain a favorably adjudicated Public Trust Clearance.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ

Become a part of our caring community and help us put health first The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Where You Come In The Fraud and Waste Professional 2 coordinates investigation with internal and external entities including compliance, internal business partners, and law enforcement. Assembles evidence and documentation to support successful adjudication, where appropriate. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. What Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education Use your skills to make an impact WORK STYLE: Remote anywhere in US, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS: Monday-Friday, 8 hours/day, 5 days/week, ideally, associates will work on EST (regardless of their home time zone). Must start between 6AM-9AM (in the employee's time zone), some flexibility might be possible, depending on business needs. Required Qualifications - What it takes to Succeed Bachelor's degree or equivalent work experience Minimum 2 years of investigative and/or claims experience Knowledge of healthcare payment methodologies Strong organizational, interpersonal, and communication skills Inquisitive nature with ability to analyze data to metrics Computer literate (MS Word, Excel, Access) Strong personal and professional ethics Ability to travel up to 5%, to attend trainings and meetings, as required Preferred Qualifications Bilingual in Spanish Bachelor's degree and/or additional degrees and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). Understanding of healthcare industry, claims processing and investigative process development. Experience in a corporate environment and understanding of business operations Additional Information Work at Home Requirements • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested • Satellite, cellular and microwave connection can be used only if approved by leadership • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 01-22-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Mercury is building a banking* stack for startups. We work hard to create the easiest and safest banking* experience possible to simplify entrepreneurs' and business owners' financial lives. We're looking to hire a Senior Account Fraud QC Investigator to support quality control for account fraud alert investigations across Mercury's consumer and business banking products. This will be the first QC hire for the Account Fraud team and a key contributor in shaping the quality framework for our newly launched BPO partnership. As a Senior Account Fraud QC Investigator, you will be responsible for designing, implementing, and executing fraud quality processes and procedures. This includes conducting quality assessments of fraud alert investigations, creating reports and dashboards, performing quality trend analysis, and translating quality insights into actionable improvements. You'll also leverage your fraud and QC expertise to contribute directly to projects that advance Mercury's account fraud program and help scale high-quality decision-making across internal teams and external partners. *Mercury is a fintech company, not an FDIC-insured bank. Banking services provided through Choice Financial Group and Column N.A., Members FDIC. Here are some things you'll do on the job: Complete manual quality assessments of account fraud alert investigations, ensuring adherence to internal policies, procedures, and applicable regulatory requirements. Partner closely with Account Fraud leadership to define and operationalize the QC program, including quality standards, scoring methodologies, and feedback loops - particularly for BPO-reviewed work. Create quality dashboards, metrics, and trend reports to surface investigation accuracy, consistency, and risks. Provide clear, actionable insights and recommendations based on quality findings to drive continuous improvement across the account fraud program. Lead and participate in quality calibration sessions with internal teams and external BPO partners to ensure consistent investigation outcomes. Assist in the development, refinement, and documentation of fraud investigation quality processes and procedures. Maintain up-to-date knowledge of fraud typologies, industry best practices, regulatory expectations, and internal policy changes to ensure quality standards remain current. Participate in special projects, internal audits, and process improvement initiatives in support of fraud quality control and program scalability. You should: Have 4+ years of experience in the finance or fintech industry with a focus on fraud investigations and quality control, ideally in an account fraud or transaction monitoring environment. Have prior experience building a QC program and/or performing QC for fraud investigations, including reviewing alerts and investigator decisioning. Have experience working with or supporting BPO or vendor-managed fraud operations. Be a highly motivated self-starter who is comfortable building structure in ambiguous, fast-moving, and high-risk environments. Have a strong understanding of banking products and fraud risk across areas such as ACH, wires, checks, debit cards, and account-level activity. Exercise empathy and sound judgment when delivering quality feedback to investigators and partners. Communicate complex findings and recommendations with efficiency and clarity to both operational and cross-functional stakeholders. The total rewards package at Mercury includes base salary, equity (stock options), and benefits. Our salary and equity ranges are highly competitive within the SaaS and fintech industry and are updated regularly using the most reliable compensation survey data for our industry. New hire offers are made based on a candidate's experience, expertise, geographic location, and internal pay equity relative to peers. Our target new hire base salary ranges for this role are the following: US employees in New York City, Los Angeles, Seattle, or the San Francisco Bay Area: $121,700 - $152,100 US employees outside of New York City, Los Angeles, Seattle, or the San Francisco Bay Area: $109,500 - $136,900 Mercury values diversity & belonging and is proud to be an Equal Employment Opportunity employer. All individuals seeking employment at Mercury are considered without regard to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, sexual orientation, or any other legally protected characteristic. We are committed to providing reasonable accommodations throughout the recruitment process for applicants with disabilities or special needs. If you need assistance, or an accommodation, please let your recruiter know once you are contacted about a role. We use Covey as part of our hiring and / or promotional process for jobs in NYC and certain features may qualify it as an AEDT. As part of the evaluation process we provide Covey with job requirements and candidate submitted applications. We began using Covey Scout for Inbound on January 22, 2024. [Please see the independent bias audit report covering our use of Covey for more information.] #LI-AR1

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under minimal direction, initiates and manages suspected fraudulent underwriting and insurance premium investigations involving the highest complexity matters. Provides advice, direction, and support to underwriters, auditors, business unit leadership, corporate investigations and other stakeholders across the organization on the detection, investigation, and litigation of suspected underwriting matters. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: * Leads the detailed analysis and completion of thorough and timely investigations of suspected underwriting fraud by following Best Practice Guidelines and collaborating with business stakeholders. * Develops and executes investigation strategy either independently or in collaboration with underwriting professionals, counsel, experts, insureds, and other stakeholders. * Manages investigation activities independently and/or coordinates/oversees vendor service partner activities in the field. * Maintains detailed, accurate and timely case records by following established Best Practices for file documentation and by creating comprehensive reports of investigative findings, and conclusions. * Makes recommendations for resolution by presenting evidence-based findings and proposing solutions of moderate to complex scope. * Identifies opportunities and participates in the design and implementation of process or procedural improvements. * Leads or directs efforts to build and enhance and oversees organizational capabilities by developing and delivering fraud awareness or regulatory compliance training and mentoring SIU staff. * Leads or directs the preparation of cases for appropriate reporting to outside agencies; leads or directs pursuit of criminal or civil actions through gathering and documenting relevant data, organizing and summarizing facts and testifying on behalf of the company in civil or criminal matters. * Continuously develops knowledge and expertise related to insurance fraud by keeping current on related law, regulations, trends, and emerging issues and participating in insurance fraud or related professional associations. May perform additional duties as assigned. Reporting Relationship Typically Manager or Director Skills, Knowledge and Abilities * Solid knowledge of property and casualty claim handling practices * Strong technical knowledge of practices and techniques related to investigations and fact finding. For roles focused in an area of specialty (medical provider investigations), strong technical knowledge of respective specialty practices is required. * Strong interpersonal, oral, and written communication skills; ability to clearly communicate complex issues * Ability to interact and collaborate with internal and external business partners, including outside agencies * Ability to work independently, exercise good judgment, and make sound business decisions * Detail oriented with strong organization and time management skills * Strong ability to analyze complex, ambiguous matters and develop effective solutions * Proficiency with Microsoft Office applications and similar business software, and understanding of relational databases information querying techniques * Ability to adapt to change and value diverse opinions and ideas * Developing ability to implement change * Ability to travel occasionally (less than 10%) Education and Experience * Bachelor's degree or equivalent professional experience. * Minimum of three to five years of experience conducting investigations in the area of a) insurance fraud, b) law enforcement, c) civil or criminal litigation, or d) similar field. * Professional certification or designation related to fraud investigations strongly preferred (e.g., CFE, CIFI, FCLS, FCLA, or similar). #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

At U.S. Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We believe it takes all of us to bring our shared ambition to life, and each person is unique in their potential. A career with U.S. Bank gives you a wide, ever-growing range of opportunities to discover what makes you thrive at every stage of your career. Try new things, learn new skills and discover what you excel at-all from Day One. Job DescriptionPartners with their assigned Line of Business, other Risk/Compliance/Audit (RCA) professionals, and RCA Managers to, depending on their function, create, implement, maintain, review or oversee an effective risk management framework. Participates in projects and/or activities that ensure compliance with applicable federal, state, and local laws and regulations. Identifies gaps and inform solutions that minimize losses resulting from inadequate internal processes, systems or human errors. Identifies, responds and/or escalates risks as appropriate. Serves as a functional liaison between the Line of Business and the Lines of Defense.Basic Qualifications - Bachelor's degree, or equivalent work experience - Typically, more than two years of applicable experience Preferred Skills/Experience - Intermediate knowledge of applicable laws, regulations, financial services, and regulatory trends that impact their assigned line of business - Intermediate understanding of the business line's operations, products/services, systems, and associated risks/controls - Basic knowledge of Risk/Compliance/Audit competencies - Strong analytical, process facilitation and project management skills - Effective presentation, interpersonal, written and verbal communication skills - Proficient computer navigation skills using a variety of software packages, including Microsoft Office applications and word processing, spreadsheets, databases, and presentations This role requires working from a U.S. Bank location three (3) or more days per week. If there's anything we can do to accommodate a disability during any portion of the application or hiring process, please refer to our disability accommodations for applicants. Benefits: Our approach to benefits and total rewards considers our team members' whole selves and what may be needed to thrive in and outside work. That's why our benefits are designed to help you and your family boost your health, protect your financial security and give you peace of mind. Our benefits include the following: Healthcare (medical, dental, vision) Basic term and optional term life insurance Short-term and long-term disability Pregnancy disability and parental leave 401(k) and employer-funded retirement plan Paid vacation (from two to five weeks depending on salary grade and tenure) Up to 11 paid holiday opportunities Adoption assistance Sick and Safe Leave accruals of one hour for every 30 worked, up to 80 hours per calendar year unless otherwise provided by law Review our full benefits available by employment status here. U.S. Bank is an equal opportunity employer. We consider all qualified applicants without regard to race, religion, color, sex, national origin, age, sexual orientation, gender identity, disability or veteran status, and other factors protected under applicable law. E-Verify U.S. Bank participates in the U.S. Department of Homeland Security E-Verify program in all facilities located in the United States and certain U.S. territories. The E-Verify program is an Internet-based employment eligibility verification system operated by the U.S. Citizenship and Immigration Services. Learn more about the E-Verify program. The salary range reflects figures based on the primary location, which is listed first. The actual range for the role may differ based on the location of the role. In addition to salary, U.S. Bank offers a comprehensive benefits package, including incentive and recognition programs, equity stock purchase 401(k) contribution and pension (all benefits are subject to eligibility requirements). Pay Range: $66,640.00 - $78,400.00 U.S. Bank will consider qualified applicants with arrest or conviction records for employment. U.S. Bank conducts background checks consistent with applicable local laws, including the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act as well as the San Francisco Fair Chance Ordinance. U.S. Bank is subject to, and conducts background checks consistent with the requirements of Section 19 of the Federal Deposit Insurance Act (FDIA). In addition, certain positions may also be subject to the requirements of FINRA, NMLS registration, Reg Z, Reg G, OFAC, the NFA, the FCPA, the Bank Secrecy Act, the SAFE Act, and/or federal guidelines applicable to an agreement, such as those related to ethics, safety, or operational procedures. Applicants must be able to comply with U.S. Bank policies and procedures including the Code of Ethics and Business Conduct and related workplace conduct and safety policies. Posting may be closed earlier due to high volume of applicants.

Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care. We are dedicated to ensuring that every person has the opportunity to understand their health, access the care they need, and contribute to the medical breakthroughs of tomorrow. With programs like Future of Medicine, which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers, which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Through partnerships, technology, and perseverance, we are reimagining how clinical research and health services reach the world. Together, we are building a future of health that is better and more accessible for all. To learn more about Care Access, visit ******************* How This Role Makes a Difference The Sub-Investigator will be responsible for regional travel mixed with remote tele-medicine work to support our clinical research. Care Access is looking for Nurse Practitioners or Physicians Assistants to support clinical trial related activities in states throughout the USA. How You'll Make An Impact * Work closely with the Principal Investigator to oversee the execution of study protocols, delegating study related duties to site staff, as appropriate, and ensuring site compliance with study protocols, study-specific laboratory procedures, standards of Good Clinical Practice (GCP), Standard Operating Procedures (SOPs), quality (QA/QC) procedures, OSHA guidelines, and other state and local regulations as applicable * Attends and participates in meetings with the director, other managers, and staff as necessary * Complies with regulatory requirements, policies, procedures, and standards of practice * Read and understand the informed consent form, protocol, and investigator's brochure * Be available to see subjects virtually or in-person as dictated by project design, answer their questions, and resolve medical issues during the study visit * Sign and ensure that the study documentation for each study visit is completed * Perform all study responsibilities in compliance with the IRB approved protocol * Review screening documentation and approves subjects for admission to study * Review admission documentation and approves subject for randomization * Provide ongoing assessment of the study subject/patient to identify Adverse Events * Ensure that serious and unexpected adverse events are reported promptly to the Pl * Review and evaluates all study data and comments to the clinical significance of any out of range results * Perform physical examinations as part of screening evaluation and active study conduct * Provide medical management of adverse events as appropriate The Expertise Required * Excellent working knowledge of medical and research terminology * Excellent working knowledge of federal regulations, good clinical practices (GCP) * Ability to communicate and work effectively with a diverse team of professionals * Strong organizational skills: Able to prioritize, support, and follow through on assignments * Communication Skills: Strong verbal and written communication skills as evidenced by positive interactions with coworkers, management, clients and vendors * Team Collaboration Skills: Work effectively and collaboratively with other team members to accomplish mutual goals. Bring positive and supportive attitude to achieving these goals * Strong computer skills with demonstrated abilities using clinical trials database, IVR systems, electronic data capture, MS word and excel * Ability to balance tasks with competing priorities * Critical thinker and problem solver * Curiosity and passion to learn, innovate, able to take thoughtful risks and get things done * Friendly, outgoing personality; maintain a positive attitude under pressure * High level of self-motivation and energy * Ability to work independently in a fast-paced environment with minimal supervision * Must have a client service mentality Certifications/Licenses, Education, and Experience: * Nurse Practitioner or Physician Assistant with 5+ years of clinical experience * Currently licensed in good standing in one or more states listed above * A minimum of 1 year of relevant work experience as Sub-Investigator (preferred) in a Clinical Research setting How We Work Together * Location: This role is 100% on-site at our Memphis, TN clinic. * Travel: This is a remote position with less than 10% travel requirements. Occasional planned travel may be required as part of the role. * Physical demands associated with this position Include: The ability to use keyboards and other computer equipment. Benefits & Perks * Paid Time Off (PTO) and Company Paid Holidays * 100% Employer paid medical, dental, and vision insurance plan options * Health Savings Account and Flexible Spending Accounts * Bi-weekly HSA employer contribution * Company paid Short-Term Disability and Long-Term Disability * 401(k) Retirement Plan, with Company Match Diversity & Inclusion We work with and serve people from diverse cultures and communities around the world. We are stronger and better when we build a team representing the communities we support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to, and will not be discriminated against on the basis of, race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Care Access is unable to sponsor work visas at this time. If you need an accommodation to apply for a role with Care Access, please reach out to: ********************************

Reporting to the Compliance Lead, the Fraud Analyst will provide fraud mitigation support through the utilization of analytic tools for fraudulent trend recognition, identifying and preventing potential fraud on customer applications and providers. The Fraud Analyst will work closely with the Compliance Lead to detect and mitigate new fraud trends, while aligning with outside departments to optimize the fraud controls and communication in place. The utilization of data & trend identification techniques will be key in the decision-making aspects of the position. What You'll Do: Perform manual reviews and analysis of new account applications and existing customer/provider accounts, identifying and preventing potential fraud Perform alert triage utilizing risk scores and trend analysis in the decisioning of alerts Manage case management for large scale fraud cases Assist Leadership in ongoing identification of high-risk behaviors of the current customer base by performing customer monitoring, assessing transactional activity, and tracking customer behavior to ensure it aligns with their expected behavior and to identify fraud among existing customer base Aggregate and analyze internal data to understand performance of fraud decisioning, finding insights from internal data sets to improve fraud mitigation strategies and customer evaluation rules to curb new fraud trends and patterns Work closely with Customer Service, Operations and Compliance teams to optimize policies and controls to improve monitoring and due diligence of transactions, consumers and providers Work closely with other departments in the identification, management and communication of fraud and ID Theft cases Leveraging AI tools to improve review efficiency and quality, including AI-generated risk summaries, memo drafting support, and automated alert triage to enhance decision-making and workflow throughput Assist with various fraud related duties as needed Perform back-office functions related to research and resolution of fraudulent activity and applicable reporting Support in ongoing bank audits, monitoring and testing, and risk assessments as applicable Monitoring industry trends relative to money laundering or fraud schemes including detection and reporting of suspicious activity Work effectively in a fully remote environment with teams spanning multiple time-zones About You: Bachelor's degree in related field; or equivalent job experience 3+ years prior banking or Fintech experience, preferably in an investigative and analytical role or exposed to fraud-related behavior in Consumer and/or Business segments Proficiency in online and internal application research across applicable systems and reporting and analytical tools An innovative and creative mind looking to suggest new solutions to old problems Detail-oriented, highly analytical and comfortable digging into data Experience/familiarity with Slack, Apple MacOS and GSuite Nice to Have: CAMS, CFCS, or CFE certification a plus

About Us Live Oak Bank is a digital bank that serves small business owners across the country. Our groundbreaking spin on service and technology has fueled our mission to be America's Small Business Bank. Our products help customers buy, build, and expand their business, and our high-yield savings and CD products help them grow their hard-earned money. At Live Oak, we never lose sight of the well-being of our people. We believe our employees are the heart of our company. Our commitment to our customers and culture is intertwined, and we seek those who embody and embrace what it takes to empower the American dream. How This Role Impacts Live Oak and its People Drive strategic decisions at Live Oak by analyzing and presenting data and supporting fraud prevention strategies. This analyst will collaborate with the fraud analyst, fraud investigators, and the investigations manager to enhance data and reporting. What You'll Do at Live Oak Design and build new data set processes for modeling, data mining, and data analysis. Provides alert support to address emerging threats. Analyze data to determine fraud system rules for fraud mitigation. Ability to communicate with management to present analysis in a concise and actionable way. How You'll Do It Implement and maintain systems/processes for data analysis and data management. Identify trends and develop assumptions to model various strategic initiatives. Responsible for gathering data from a variety of data sources and performing meaningful analysis. Regularly performs analysis and reporting as needed. Maintain proper documentation as required for record retention purposes. Required and Preferred Experience 2 years related fraud analytics experience, required Strong analytical skills, required Experience in Microsoft Office Proficiency in Data Visualization Tools such as Tableau and Python Proficiency with Database Tools (SQL Server, MySQL, etc.) Our Values Dedication: Possess a deep commitment to Live Oak Bank's mission and core values, exemplified through a strong work ethic, adaptability and pride in your work. Ownership: Take initiative to deliver positive results by proactively and creatively solving problems, while maintaining a high degree of quality. Respect: Treat everyone with courtesy, politeness, and kindness. Innovation: Embrace fresh ideas and fearlessly contribute new solutions to emerging or existing problems. Teamwork: Foster collaboration, accountability, and trust with others and understand that together, we do more For a detailed overview of our employee benefits please visit: *********************************** Live Oak Bank is an Affirmative Action and Equal Opportunity Employer, Minorities/Women/Veterans/Disabled. We consider applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, veteran status or disability. Equal access to programs, service and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify human resources at ***************************. EEO is the Law The base pay range for this position is $56,540.00 - $92,520.00 per year. Compensation may also include annual bonuses and long-term incentives, subject to various metrics and company policy. A candidate's salary is determined by several factors including travel, relevant work experience or skills and expertise. Please note that we provide at least the minimum requirement of paid sick leave to our employees who reside in states that require employer-paid sick leave, including but not limited to Arizona, California, Colorado, District of Columbia, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.

About Us Live Oak Bank is a digital bank that serves small business owners across the country. Our groundbreaking spin on service and technology has fueled our mission to be America's Small Business Bank. Our products help customers buy, build, and expand their business, and our high-yield savings and CD products help them grow their hard-earned money. At Live Oak, we never lose sight of the well-being of our people. We believe our employees are the heart of our company. Our commitment to our customers and culture is intertwined, and we seek those who embody and embrace what it takes to empower the American dream. How This Role Impacts Live Oak and its People Drive strategic decisions at Live Oak by analyzing and presenting data and supporting fraud prevention strategies. This analyst will collaborate with the fraud analyst, fraud investigators, and the investigations manager to enhance data and reporting. What You'll Do at Live Oak Design and build new data set processes for modeling, data mining, and data analysis. Provides alert support to address emerging threats. Analyze data to determine fraud system rules for fraud mitigation. Ability to communicate with management to present analysis in a concise and actionable way. How You'll Do It Implement and maintain systems/processes for data analysis and data management. Identify trends and develop assumptions to model various strategic initiatives. Responsible for gathering data from a variety of data sources and performing meaningful analysis. Regularly performs analysis and reporting as needed. Maintain proper documentation as required for record retention purposes. Required and Preferred Experience 2 years related fraud analytics experience, required Strong analytical skills, required Experience in Microsoft Office Proficiency in Data Visualization Tools such as Tableau and Python Proficiency with Database Tools (SQL Server, MySQL, etc.) Our Values Dedication: Possess a deep commitment to Live Oak Bank's mission and core values, exemplified through a strong work ethic, adaptability and pride in your work. Ownership: Take initiative to deliver positive results by proactively and creatively solving problems, while maintaining a high degree of quality. Respect: Treat everyone with courtesy, politeness, and kindness. Innovation: Embrace fresh ideas and fearlessly contribute new solutions to emerging or existing problems. Teamwork: Foster collaboration, accountability, and trust with others and understand that together, we do more For a detailed overview of our employee benefits please visit: *********************************** Live Oak Bank is an Affirmative Action and Equal Opportunity Employer, Minorities/Women/Veterans/Disabled. We consider applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, veteran status or disability. Equal access to programs, service and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify human resources at ***************************. EEO is the Law The base pay range for this position is $56,540.00 - $92,520.00 per year. Compensation may also include annual bonuses and long-term incentives, subject to various metrics and company policy. A candidate's salary is determined by several factors including travel, relevant work experience or skills and expertise. Please note that we provide at least the minimum requirement of paid sick leave to our employees who reside in states that require employer-paid sick leave, including but not limited to Arizona, California, Colorado, District of Columbia, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.

Qualified candidates are interested in utilizing their investigative skills to conduct a variety of investigations on insurance related matters; such as auto and property theft, fire damages, auto accidents, commercial claims, finding missing persons, courthouse searches, and other investigative tasks. For this position, you will also need to be fluent in writing, reading and speaking Spanish. This is a remote opportunity for part-time employment in our Special Investigations Unit (SIU). As an SIU Investigator, you will be joining an incredible team of investigators and industry leaders. PRINCIPAL RESPONSIBILITIES: Complete recorded detailed interviews of those insured, claimants, witnesses, and others as identified. Complete scene investigations, including photographing. Conduct in-person visit of medical clinics. Complete neighborhood canvasses. Make sound judgments during the course of the investigation. Provide timely progress updates. Complete detailed investigative reports. WHO SHOULD APPLY: Candidates with at least five (5) years of investigations experience are strongly encouraged to apply. We are looking for people who are enthusiastic about investigations, those who thrive in a diverse work environment, and individuals who have a commitment to the very highest standards of honesty, integrity, and respect. POSITION QUALIFICATIONS: MUST have current and active Private Investigation License to be eligible for hire. Self-motivated, determined, and intuitive with a strong initiative and work-ethic. Ability to identify critical issues quickly and accurately. Demonstrate observational, organizational, and listening skills. Excellent oral and written communication. Fluent in Spanish language (writing, reading, speaking). Ability to work independently, as well as in a team. Flexible schedule working weekends, holidays, and possible evenings. Candidate must own a reliable computer, preferably a laptop, with access to high-speed internet and a scanner or fax machine. Must have strong computer and internet skills. Proficient with a digital camera. Must possess a valid driving license and own your reliable vehicle. Applicants must pass an extensive background check. Must be able to pass a drug test with negative results (except when undergoing documented medical treatment). College Degree preferred. COMPENSATION & REIMBURSEMENTS: Hourly Rate is commensurate with education and experience. Paid travel time and reimbursement for mileage, tolls, and other per diem items. READY TO APPLY? Please submit your FULL resume, including salary requirements.

Investigator External Audit Special Investigations Unit \*Remote* The SIU Audit Investigator supports the compliance related activities of the Special Investigations Unit (SIU) at the Health Plan. This role assists the External Audit Senior Manager with developing, implementing and performing compliance related auditing and monitoring activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and coding practices; coordination of recovery of overpayments related to fraudulent and/or abusive billing and coding practices; and providing education related to coding, medical record documentation requirements, healthcare compliance and fraud, waste and abuse to Health Plan staff, vendors and contracted providers/facilities. Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. _Providence Health Plan welcomes 100% remote work for applicants who reside in the following states:_ + Washington + Oregon + California Required Qualifications: + Bachelor's Degree Or equivalent combination of education and experience. + 5 years Coding experience with a healthcare provider, facility or health insurance company. + 2 years Fraud and Abuse audit experience in a health insurance company, healthcare provider, facility or other relevant healthcare environment. + Project management experience, education program development experience and group presentation experience. + Experience in use of data mining software/tools. Preferred Qualifications: + Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. + Certification as an Internal Auditor or Healthcare Compliance certification upon hire. + Clinical background. Salary Range by Location: California: Humboldt: Min: $29.62, Max: $45.31 California: All Northern California - Except Humboldt: Min: $33.23, Max: $50.84 California: All Southern California - Except Bakersfield: Min: $29.62, Max: $45.31 California: Bakersfield: Min: $28.41 Max: $43.47 Oregon: Non-Portland Service Area: Min: $26.49, Max: $40.52 Oregon: Portland Service Area: Min: $28.41 Max: $43.47 Washington: Western - Except Tukwila: Min: $29.62, Max: $45.31 Washington: Southwest - Olympia, Centralia & Below: Min: $28.41 Max: $43.47 Washington: Tukwila: Min: $29.62, Max: $45.31 Washington: Eastern: Min: $25.28, Max: $38.68 Washington: South Eastern: Min: $26.49, Max: $40.52 Why Join Providence Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Requsition ID: 405395 Company: Providence Jobs Job Category: Internal Audit Job Function: Finance Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 5018 COMPLI PAYMENT INTEGRITY OR REGION Address: CA Oakland 540 23rd St Work Location: Providence House Oakland-Oakland Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

What we're looking for, ranked: You have obsessive attention to detail. You are analytical and love finding patterns in data. You are scrappy, have a bias for action, and work harder than anyone you know. You have experience working in risk or fraud, especially in e-commerce or payments. About Whop Whop is the ultimate virtual market that lets people earn money by starting shops and creating content. We deliver $2.5B per year in income to people across the globe and have more than 5M monthly users. About the role As a Fraud Specialist, you will make sure that merchants are only selling high-quality, trusted products on Whop and all activity on the platform falls within our Terms of Service. You will leverage Whop's fraud tools to investigate payment anomalies, review high-risk merchant flags, and escalate situations as needed. This role reports to the Head of Trust. ✅ Salary: $60,000 📍Remote : This position offers the flexibility to work from anywhere in the world. Available shifts are: 12:00 am EST to 8 am EST 8:00 am EST to 4:00 pm EST 4:00 pm to 12:00 am EST Weekend shifts are rotational - you must be available to work on some weekends. Scope: Responsible for Whop merchant account audits, reviewing risk flags from our internal fraud tooling and setting reserves or suspending accounts accordingly Review merchant applications to access financing options, including review of payment processor statements Escalate fraudulent trends to product and engineering teams so we can build solutions into our product What we're looking for You have previous experience in risk, compliance, or a similar role. You have a deep understanding of risk and fraud at an ecommerce or payments company. You are familiar with Whop, either as a buyer or as a seller. You have obsessive attention to detail; you care deeply about correctness You are low-ego, non-performative, and process-driven You love getting creative and doing anything it takes to solve a hard problem You are scrappy and have a bias for action: no task too small, no idea too big You want to take over the world and are not satisfied with anything other than being the best Your first 90 days will look like the following: Within 30 days, you will deeply understand Whop's product and internal fraud tools and processes. Within 60 days, you will have mastered account audits, financing application reviews, Resolution Center cases, and escalations. Within 90 days, you are detecting fraud patterns and escalating trends to our engineering teams to update fraud solutions within our product.

Salary: $120k-$165k + Bonus For more information on benefits and what we offer please visit us at *************************************************** The EXL - Fraud Practice will be responsible for shaping, scaling, and executing integrated fraud management solutions for EXL. The role will focus on helping global banks and financial institutions to reduce their fraud losses and modernize their fraud ecosystems - embedding AI, GenAI, and automation across the lifecycle. This role demands a candidate who brings deep fraud domain expertise, consulting acumen, and the ability to translate technology and analytics into measurable business outcomes. Minimum 5 years of experience in Fraud analytics, Strategy, or Risk Management, preferably across Banking, Fintech, or Payments. Proven ability to lead multi-dimensional transformation integrating analytics, digital, operations, and advisory levers. Deep domain understanding across the fraud lifecycle - including application, transaction, merchant, and dispute/chargeback management. Experience with fraud platforms, rules strategy configuration, and decision orchestration tools. Strong client engagement and consulting skills with ability to influence senior stakeholders and CXO-level clients. Exposure to Operational Excellence and continuous improvement frameworks. Excellent communication, presentation, and storytelling skills with a data-driven orientation. Graduate or Postgraduate in Statistics, Economics, Finance, or an MBA with relevant domain experience. High energy, intellectual curiosity, and self-driven mindset, comfortable operating in fast-evolving, ambiguous environments. EEO/Minorities/Females/Vets/Disabilities Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits. Lead short-cycle diagnostic and transformation initiatives across the fraud value chain - identifying pain points, quantifying impact opportunities, and developing executable roadmaps. Support sales and client pursuits by leading solution design, RFP/RFI responses, and development of differentiated value propositions. Drive end-to-end transformation programs leveraging analytics, AI-first frameworks, and automation to optimize fraud prevention, detection, and claims management. Conduct research and benchmarking to generate actionable insights on emerging fraud typologies, regulatory shifts, and best-in-class practices. Develop and continuously evolve knowledge assets including capability decks, frameworks, case studies etc. to strengthen the fraud offering. Evangelize fraud and disputes solutions by collaborating with delivery, digital, and analytics teams to embed innovation and enhance solution maturity. Identify performance bottlenecks and enable data-driven interventions to drive measurable outcomes in fraud savings, false positive reduction, and recovery rates. Build domain and analytics capability through structured training programs, certification paths, and knowledge transfer across global delivery teams.

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Fraud Analyst in the United States.This role offers the opportunity to take full ownership of fraud detection and prevention within a fast-growing, data-driven environment. You will analyze large datasets, identify fraud patterns, and design risk logic to protect users and optimize transactions. The position combines strategic thinking with hands-on execution, allowing you to shape verification strategies, optimize authentication flows, and improve approval rates while maintaining a seamless user experience. You will collaborate closely with product, payments, data, and engineering teams, gaining exposure to multiple markets and complex payment systems. The ideal candidate thrives on autonomy, accountability, and leveraging data to drive actionable outcomes. This role provides a chance to make a tangible impact on a global, high-volume marketplace.Accountabilities: Take ownership of fraud detection and prevention for assigned products Analyze large datasets using SQL to identify patterns, anomalies, and emerging attack vectors Design, implement, and optimize dynamic fraud risk rules to scale with business growth Monitor and improve False Positive Rates, balancing security and user experience Manage 3DS decisioning and authentication strategies across multiple regions Track and report fraud trends, providing data-driven insights and recommendations Collaborate with Product, Payments, Data, and Engineering teams to enhance fraud prevention systems Maintain fraud detection workflows, alerts, and decision logic used by the team Requirements: Proven experience in fraud analysis, payments risk, or risk management with clear ownership over results Strong SQL skills and hands-on experience with large datasets (mandatory) Experience creating and maintaining dynamic fraud risk rules Knowledge of 3DS and regional authentication strategies Ability to manage False Positive Rates and approval rates effectively Solid understanding of fraud patterns, user behavior, and payment-related risks Strong problem-solving, critical thinking, and data-backed decision-making skills Full professional proficiency in English Nice-to-Haves: Python experience, familiarity with fintech/payment tools (e.g., Adyen, Stripe Radar, Sift, Forter), experience in multi-market international environments, and knowledge of PSD2/SCA concepts Benefits: Competitive salary range (€37,200 - €42,780, depending on experience) Employee Stock Options program Performance-based bonuses, referral bonuses, and additional paid leave Personal learning and professional development budget Paid volunteering opportunities Flexible work location: office, remote, or hybrid, with opportunities to travel Clear growth and promotion processes with structured feedback Why Apply Through Jobgether?We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1

Vercel gives developers the tools and cloud infrastructure to build, scale, and secure a faster, more personalized web. As the team behind v0, Next.js, and AI SDK, Vercel helps customers like Ramp, Supreme, PayPal, and Under Armour build for the AI-native web. Our mission is to enable the world to ship the best products. That starts with creating a place where everyone can do their best work. Whether you're building on our platform, supporting our customers, or shaping our story: You can just ship things. About the Role: We're seeking a Fraud Specialist to join our Trust & Safety team, which protects the integrity of our platform across key abuse areas such as fraud, phishing, malware, CSAM, platform abuse, and IP/DMCA infringement. In this role, you will collaborate across Operations, Product, Finance, and Engineering teams to strengthen and scale Vercel's fraud prevention capabilities. You'll analyze fraudulent activity, refine detection systems, develop operational processes, and help mitigate risk to both our users and the business. If you're based within a pre-determined commuting distance of one of our offices (SF, NY, London, or Berlin), the role includes in-office anchor days on Monday, Tuesday, and Friday. If you're located beyond that distance, the role is fully remote. For location-specific details, please connect with our recruiting team. What You Will Do: Investigate abuse vectors causing financial loss or reputational risk to the business. Monitor, maintain, and improve fraud detection and anomaly alerting systems. Develop and refine operational workflows to scale fraud prevention efforts. Manage and monitor the performance of internal tooling and fraud rules. Work cross-functionally across, Operations, Engineering, Product, and Finance to mitigate areas of risk. Represent Trust & Safety during incident response and create mitigation processes. About You: 3+ years of experience in fraud or chargeback operations, investigations, or a related Trust & Safety vertical. Experience with user restriction systems and setting, tracking, and using KPIs to understand and optimize operations workflows and outcomes. Proven track record working cross-functionally to deliver impactful results. Strong attention to detail, and the ability to translate investigations into scaled systems. Worked with abuse detection systems that leveraged Machine Learning and/or LLMs for large-scale anti-fraud enforcement. Ability to take large data sets and distill key insights into actionable trends and strategies. Bonus If You: Experience across multiple Trust & Safety domains, especially when it comes to web hosting or user generated content. Ability to create and interpret SQL queries. Experience using abuse-related ticketing and case management systems. Understanding of chargebacks and the overall payments landscape. Benefits: Competitive compensation package, including equity. Inclusive Healthcare Package. Learn and Grow - we provide mentorship and send you to events that help you build your network and skills. Flexible Time Off. We will provide you the gear you need to do your role, and a WFH budget for you to outfit your space as needed. The San Francisco, CA base pay range for this role is $128,000 - $192,000. Actual salary will be based on job-related skills, experience, and location. Compensation outside of San Francisco may be adjusted based on employee location. The total compensation package may include benefits, equity-based compensation, and eligibility for a company bonus or variable pay program depending on the role. Your recruiter can share more details during the hiring process. Vercel is committed to fostering and empowering an inclusive community within our organization. We do not discriminate on the basis of race, religion, color, gender expression or identity, sexual orientation, national origin, citizenship, age, marital status, veteran status, disability status, or any other characteristic protected by law. Vercel encourages everyone to apply for our available positions, even if they don't necessarily check every box on the job description. #LI-LC1

Please note: while we appreciate interest from all applicants, Braviant Holdings is unable to sponsor visas at this time. Who We Are:Founded in 2015 and based in Chicago, IL, privately held Braviant Holdings, Inc is a leading providerof tech- enabled credit products which combine breakthrough technology and cutting-edge machinelearning to transform how people access credit online. The Company's next-generation approach to lendingreduces credit barriers and creates a Path to Prime helping millions of underbanked consumers build credithistory, reduce their cost of borrowing, and take control of their personal finances. Braviant has beennamed multiple times to the Inc. 5000 list of fastest growing private companies and has beenrecognized as a Best Place to Work. Position Summary:Reporting to the Chief Growth & Strategy Officer, the Fraud Analytics Lead role is a compellingopportunity for a data-driven professional with strong expertise to design and execute fraud and riskmitigation strategies. The successful candidate will leverage advanced analytics to optimize businessoperations and develop proactive fraud prevention solutions. This role requires a combination ofcritical thinking, technical expertise, and the ability to collaborate with partners across Operations,Credit, Technology and Compliance to identify, mitigate, and solve complex business challenges.What you'll be doing: Monitor applications, transactions, and customer activity to detect and prevent fraud and identity risks such as synthetic identities, account takeovers, and first-party fraud. Apply machine learning models and statistical techniques to enhance fraud detection and prevention capabilities. Access and manage fraud and verification tools and data providers to ensure effectiveness and ROI Develop and maintain dashboards to track key fraud and risk performance metrics Stay current on industry best practices, regulatory requirements, and emerging technologies in online-lending fraud prevention Partner with Operations, Credit, Technology and Compliance to align fraud strategies with enterprise objectives What you'll bring: Degree in Data Science, Applied Mathematics, Statistics, Economics, Computer Science or a related field 4-6 years of experience in fraud analytics, data science, or a related field within FinTech or online lending space. Advanced proficiency in Python for programming, data analysis, and predictive modeling Proficiency in SQL, Excel and experience with data visualization tools Knowledge of optimization, stochastic processes, experimental design and A/B testing Strong knowledge of various fraud typologies impacting online financial services, relevant regulatory requirements and compliance framework Passion for keeping your skills up to date and exploring new methodologies The ability to distill complex problems and analysis into a clear and concise narrative Benefits and Perks• Medical benefits paid by employer/employee split of 80/20• Dental and Vision covered at zero cost to you for employee only coverage• PTO, Sick and Floating Holidays• 14 Company Holidays• Participation in the Company Profits Interest Units long term incentive plan• Remote work environment• Internet stipend• Team and company events/get togethers Braviant is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, or any other characteristic protected by applicable law