Fraud investigator work from home jobs - 60 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

Employee Applicant Privacy Notice Who we are: Welcoming, collaborative and having the opportunity to make an impact - is how our employees describe working here. Galileo is a financial technology company that provides innovative and revolutionary software products and services that power some of the world's largest Fintechs. We are the only payments innovator that applies tech and engineering capabilities to empower Fintechs and financial institutions to unleash their full creativity to achieve their most inspired goals. Galileo leads its industry with superior fraud detection, security, decision-making analytics and regulatory compliance functionality combined with customized, responsive and flexible programs to accelerate the success of all payments companies and solve tomorrow's payments challenges today. We hire energetic and creative employees while providing them the opportunity to excel in their careers and make a difference for our clients. Learn more about us and why we work here at ********************************************** Job Description Compensation and Benefits The base pay range for this role is listed below. Final base pay offer will be determined based on individual factors such as the candidate's experience, skills, and location. This role may also be eligible for a bonus and/or long term incentives. Your recruiter will provide more information to you. All roles are eligible for competitive benefits. More information about our employee benefits can be found in the link below. Benefits To view all of our comprehensive and competitive benefits, visit our Benefits at SoFi & Galileo page! US-Based Base Compensation$25.60-$47.70 USDGalileo Financial Technologies provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion (including religious dress and grooming practices), sex (including pregnancy, childbirth and related medical conditions, breastfeeding, and conditions related to breastfeeding), gender, gender identity, gender expression, national origin, ancestry, age (40 or over), physical or medical disability, medical condition, marital status, registered domestic partner status, sexual orientation, genetic information, military and/or veteran status, or any other basis prohibited by applicable state or federal law. The Company hires the best qualified candidate for the job, without regard to protected characteristics. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. New York applicants: Notice of Employee Rights Galileo is committed to an inclusive culture. As part of this commitment, Galileo offers reasonable accommodations to candidates with physical or mental disabilities. If you need accommodations to participate in the job application or interview process, please let your recruiter know or email accommodations@sofi.com. Due to insurance coverage issues, we are unable to accommodate remote work from Hawaii or Alaska at this time. Internal Employees If you are a current employee, do not apply here - please navigate to our Internal Job Board in Greenhouse to apply to our open roles.

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Fraud Investigator in the United States.In this critical role, you will lead complex investigations into high-impact fraud cases across multiple payment channels, protecting clients' financial assets and operational integrity. You will analyze transactional data, identify suspicious patterns, and determine the root cause of fraudulent activity. Acting as a trusted advisor to both internal teams and clients, you will deliver actionable insights, present findings, and recommend risk mitigation strategies. Collaboration is key, as you will work with cross-functional teams and external platforms to resolve cases efficiently and in compliance with regulatory standards. This role combines analytical rigor, investigative expertise, and operational leadership in a dynamic, fast-paced environment.Accountabilities: Lead end-to-end investigations into complex fraud cases, ensuring timely and thorough resolution Analyze transactional data across multiple sources to detect patterns, trends, and emerging fraud typologies Prepare and present detailed reports for clients, highlighting findings, trends, and recommended actions Collaborate with internal operations and support teams to ensure accurate documentation, escalation, and resolution of cases Review customer claims across debit cards, credit cards, ACH, P2P, bill payments, and other payment channels Identify process gaps and recommend procedural enhancements to strengthen fraud prevention Maintain investigative procedures and serve as a subject matter expert for escalated inquiries Track and report investigation metrics, staying current on industry trends, regulatory changes, and compliance requirements Mentor and train Fraud Analysts in investigative techniques and case handling Requirements: Associate's degree in Business, Criminal Justice, Finance, or related field preferred Minimum 5 years of experience in fraud investigation or advanced fraud analysis in financial services or fintech Proven track record managing complex investigations from initiation to resolution Expertise with fraud detection platforms (e.g., Verafin, DataVisor) and multi-system analysis Fraud certification (CFE, CFCI, or equivalent) strongly preferred Strong understanding of banking operations, payment systems, and regulatory requirements Exceptional analytical, research, and problem-solving skills with strong attention to detail Excellent written and verbal communication, including preparing and delivering reports to diverse audiences Ability to work independently while collaborating effectively with cross-functional teams Proficient in Microsoft Office, Google applications, and data analysis tools Benefits: $65,000 - $75,000 annual salary, plus annual cash bonus and equity options Fully remote work environment 401(k) plan with company match Comprehensive health, dental, and vision insurance (company-covered premiums) Flexible paid time off policy Opportunities for professional growth in a fast-paced fintech environment 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

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!

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

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

Become a part of our caring community and help us put health first Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit. Do you enjoy speaking with members, providers, and other industry colleagues? Do you thrive on solving problems and thinking outside the box? Are you self-driven and enjoy being proactive? But, most of all do you have a passion for combating Fraud, Waste, and Abuse in the Health Care Industry? If this resonates with you, then you should strongly consider this amazing opportunity to join Humana's SIU. The Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Fraud and Waste Investigator collaborates in investigations with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares investigative and audit reports. Begins to influence department's strategy. Makes decisions on issues regarding technical approach for project components. Exercises good judgment with considerable latitude in determining objectives and approaches to assignments. In order to thrive in this role, the following attributes and experience would be helpful: o Self-starter and organized o Interview skills and able to conduct a thorough investigation to maintain compliance with Humana and governmental requirements o Able to collaborate with internal and external partners (Law Enforcement, Legal, Compliance). o Comfort with data analysis (Excel, Access, PowerBI), report writing, and creating/presenting via PPT or other platform o Performing Investigative research and medical record reviews o CPT code experience o Experience with testifying in Court This role will regularly engage with all of the following: o Local, State and Federal Law Enforcement o Humana Legal and Outside Counsel o Internal Compliance o Market Areas o Clinical Teams o Business areas for all product lines (Medicare, Medicaid, Commercial) o Industry Trend areas Use your skills to make an impact WORK STYLE: Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS: Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. EST/CST time zones Required Qualifications • Bachelor's degree • 2 years of healthcare fraud investigations and auditing experience • Knowledge of healthcare payment methodologies, claims, submissions, and payments • Strong organizational, interpersonal, and communication skills • Inquisitive nature with ability to analyze data to metrics • Proficiency with MS Word, Excel, Access • Strong personal and professional ethics • Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications • Graduate degree and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) • Experience testifying in court • 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 • WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. • Satellite and Wireless Internet service is NOT allowed for this role. • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information How We Value You • Benefits starting day 1 of employment • Competitive 401k match • Generous Paid Time Off accrual • Tuition Reimbursement • Parent Leave • Go365 perks for well-being Interview Format As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. 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. #ThriveTogether #WorkAtHome 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: 01-15-2026 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

Our Company At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate has the opportunity to learn and grow. We strive to create a work environment to meet associate needs and we are determined to achieve excellence in everything we do. This is an opportunity to join a dynamic team in a company that is a leader in the non-standard auto insurance space and functions with a small company, entrepreneurial style. This position will require someone with an understanding that one needs to have a “roll up your sleeves” attitude to help make things happen. Job Summary The SIU Investigator is responsible for conducting thorough investigations throughout the 10 states in which we conduct business. The Investigator is responsible for analytical review of suspicious claims utilizing various investigative methods and techniques. The investigator must evaluate relevant information essential in resolving suspicious and complex investigations. This position requires demonstrated effectiveness in the understanding and application of legal and claim principles. The SIU Investigator works under minimal supervision outside the office and would have access to transportation. Only candidates located in the Orlando area will be considered. This is a field position. Please note a company car provided. Job Responsibilities Supports Claims Department operations in the research and investigation of suspicious or questionable property damage and injury claims Conducts recorded statements and Examinations Under Oath as required Completes field work as required. Documents claim files and communicates in writing as required Provides office training to ensure recognition of potentially suspicious or fraudulent files in the branch Reports suspicious claims to the department of insurance as required by statute Must ensure compliance with industry and company policies Must understand regulatory / statutory requirements; develops and maintains knowledge of changes in law both at state and national levels Properly utilizes our claims and other various systems Attends industry meetings for communication trends Completes individual monthly Investigator report to manager Attends and participates in team meetings Participates in roundtable meetings Actively affiliates and maintains network of SIU, claims, law enforcement, attorney and related contacts to ensure investigation methods are current and proper operating procedures are utilized Responsible for meeting individual goals and objectives Maintains consistent, fair and diplomatic interactions with co-workers Performs other duties as assigned by SIU Manager Job Qualifications Formal Education & Certification Undergraduate College Degree or equivalent work experience will be considered. Knowledge & Experience 5 years of special investigation experience required. Casualty and PIP claims, as well as medical clinic investigations will be highly preferred. Claims and Property Damage investigations experience will be required. Skills & Competencies Must be able to work in a fast-paced, paperless/automated production environment. Excellent PC skills are required. Excellent communication/interpersonal skills and ability to work with all levels within the organization and deal tactfully and diplomatically with public and outside authorities. Must be able to work as a team player throughout the company. Ensures that the highest degree of professionalism and integrity is maintained, and that decisions are made within the scope of what is fair, reasonable and appropriate according to applicable law and industry standards. Must have the ability to travel when necessary. Bilingual preferred. Florida Adjuster's license is required prior to employment start date.

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: ********************************

The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members. Researches, gathers, and analyzes data to identify trends, patterns, aberrancies, and outliers in provider billing behavior. Serves as a subject matter expert for other investigators. Qualified candidates must live in Massachusetts or surrounding states. Essential Functions: Develop, coordinate and conduct strategic fact-driven investigative projects including business process review, execution of investigative activities, and development of investigation outcome recommendations Manage the development, production, and validation of reports generated from detailed claims, eligibility, pharmacy, and clinical data and translate analytical findings into actionable items Manage strategic investigative plan and drive investigative outcome for the team Ensure quality outcomes for investigative team through auditing and oversight Prioritize, track, and report status of investigations Report identified corporate financial impact issues Use concepts and knowledge of coding guidelines to analyze complex provider claim submissions Research, comprehend and interpret various state specific Medicaid, federal Medicare, and ACA/Exchange laws, rules and guidelines Identify, research and comprehend medical standards, healthcare authoritative sources and apply knowledge to investigative approach Collaborate with data analytics team and utilize RAT STATS on Statistically Valid Random Sampling Coordinate and conduct on-site and desk audits of medical record reviews and claim audits Manage and decision claims pended for investigative purposes Maintain a working knowledge of all state and federal laws, rules, and billing guidelines for various provider specialty types Prepare and conduct in-depth complex interviews relevant to investigative plan Execute and manage provider formal corrective action plans Participate in meetings with operational departments, business partners, and regulatory partners to facilitate investigative case development Participate in meetings with Legal General Counsel to drive case legal actions, formal corrective actions, negotiations with recovery efforts, settlement agreements, and preparation of evidentiary documents for litigation Present, support, and defend investigative research to seek approval for formal corrective actions Establish and maintain relationships with Federal and State law enforcement agencies, task force members, other company SIU staff and external contacts involved in fraud investigation, detection and prevention SME in the designated market and ability to apply external intelligence to their analysis and case development Develop and present internal and external formal presentations, as needed Attend fraud, waste, and abuse training/conferences, as needed Support regulatory fraud, waste, and abuse reports to federal and state Medicare/Medicaid agencies Manage and maintain sensitive confidential investigative information Maintain compliance with state and federal laws and regulations and contracts Adhere to the CareSource Corporate Compliance Plan and the Anti-Fraud Plan Assist in Federal and State regulatory audits, as needed Perform any other job-related instructions, as requested Education and Experience: Bachelor's Degree or equivalent years of relevant work experience in Health-Related Field, Law Enforcement, or Insurance required Master's Degree (e.g., criminal justice, public health, mathematics, statistics, health economics, nursing) preferred Minimum of five (5) years of experience in healthcare fraud investigations, medical coding, pharmacy, medical research, auditing, data analytics or related field is required Competencies, Knowledge and Skills: Intermediate proficiency level in Microsoft Office to include Outlook, Word, Excel, Access, and PowerPoint Effective listening and critical thinking skills and the ability to identify gaps in logic Strong interpersonal skills, high level of professionalism, integrity and ethics in performance of all duties Excellent problem solving and decision making skills with attention to details Background in research and drawing conclusions Ability to perform intermediate data analysis and to articulate understanding of findings Ability to work under limited supervision with moderate latitude for initiative and independent judgment Ability to manage demanding investigative case load Ability to develop, prioritize and accomplish goals Self-motivated, self-directed Strong written skills with ability to compose detailed investigative reports and professional internal and external correspondences Presentation experience, beneficial Knowledge of Medicaid, Medicare, healthcare rules preferred Background in medical terminology, CPT, HCPCS, ICD codes or medical billing preferred Complex project management skills preferred Display leadership qualities Licensure and Certification: One of the following certifications is required: Accredited Healthcare Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) Certified Professional Coder (CPC) is preferred NHCAA or other fraud and abuse investigation training is preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Occasional travel (up to 10%) to attend meetings, training, and conferences may be required Compensation Range: $70,800.00 - $113,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SD1

Job DescriptionDescription: The CBS Difference Cooperative Business Services offers a comprehensive, end-to-end commercial lending solution that empowers financial institutions with cutting-edge software, expert services, and strategic business development resources. Additionally, we support borrowers by providing tailored business loans designed to fuel growth and success. With a focus on innovation and collaboration, CBS ensures seamless processes and enhanced opportunities for lenders and borrowers alike. At CBS, our goal is to set the standard for excellence in business lending. We strive to be the best - in our processes, in our service, and in the results, we help our clients achieve. We're deeply committed to serving our partner credit unions and borrowers with integrity, precision, and a shared vision for sustainable growth. Join us on this journey as we continue to transform the future of commercial lending. Your Role in Our Success The Commercial Loan Fraud Specialist conducts comprehensive credit and forensic reviews of commercial loans. The Officer ensures underwriting quality, regulatory compliance, and risk mitigation. This position performs deep-dive financial analysis to identify fraud, misrepresentation, or policy exceptions across the commercial loan portfolio. Here's how you will make an impact: Performs in-depth reviews of commercial loans to assess underwriting quality, loan structure, financial analysis, compliance with internal policies and regulatory requirements. Traces borrower and affiliate financial transactions from loan inception to identify inconsistencies, undisclosed relationships, or unusual fund movements. Investigates potential fraud, misrepresentation, or conflicts of interest involving borrowers, brokers, or originators to safeguard the organization's assets. Reviews insurance coverage, appraisals, environmental reports, and title documentation to verify accuracy and compliance. Identifies and documents exceptions in title searches, policies, and loan documentation to ensure proper risk mitigation and record-keeping. Prepares detailed investigative reports outlining findings, risk implications, and recommended corrective actions for management. Collaborates closely with credit, compliance, legal, and risk management teams to address identified issues and strengthen controls. Preforms other related duties as assigned by management. Requirements: What You Bring to the Table Bachelor's degree in finance, accounting, forensic accounting, or related field (Certified Public Accountant, Certified Fraud Examiner, or Certified Regulatory Compliance Manager designations preferred). 5+ years of experience in commercial lending, loan review, forensic accounting, or financial investigations. Strong knowledge of banking regulations, loan documentation, and fraud detection techniques. The Perks of Being with Us At Cooperative Business Services, we believe in creating an environment where you can thrive both personally and professionally. Here's what you can look forward to as a valued member of our team: Compensation: Base compensation for this role ranges from $78,000-$90,000 annually. Remote Work Environment Generous Holidays: Take advantage of 13 paid holidays each year Comprehensive Insurance Coverage: Choose from a selection of medical, dental, vision, and supplemental benefit plans to suit your needs. Additionally, the company provides company-paid Short-Term Disability (STD), Long-Term Disability (LTD), and life insurance equivalent to 1 time your salary. 401(k) Plan: The company provides a generous matching contribution of up to 6%. Tuition Assistance

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.

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.

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

At Thermo Fisher Scientific, you'll discover meaningful work that makes a positive impact on a global scale. Join our colleagues in bringing our Mission to life - enabling our customers to make the world healthier, cleaner and safer. We provide our teams with the resources needed to achieve individual career goals while taking science a step beyond through research, development and delivery of life-changing therapies. With clinical trials conducted in 100+ countries and ongoing development of novel frameworks for clinical research through our PPD clinical research portfolio, our work spans laboratory, digital and decentralized clinical trial services. Your determination to deliver quality and accuracy will improve health outcomes that people and communities depend on - now and in the future. Our Mission is to enable our customers to make the world healthier, cleaner and safer. As one team of 100,000+ colleagues, we share a common set of values - Integrity, Intensity, Innovation and Involvement - working together to accelerate research, solve complex scientific challenges, drive technological innovation and support patients in need. Summarized Purpose: Prepares, reviews and finalizes global investigator grant budget and payment schedule terms and conditions templates for multiple studies. Develops investigator grant budget negotiation parameters with clients, communicates client processes, procedures and negotiation parameters to local team members. Liaises and establishes effective relationships with clients and internal PPD functional teams and Contract Specialists as directed by Contract Managers. This is a fully remote position for applicants located in the United States of America. Essential Functions: Assists in the development of investigator grant budget grids for applicable countries in assigned studies inclusive of coordination with therapeutic and operational subject matter experts, as appropriate, to ensure proper grant development. Drafts applicable payment terms and condition templates for investigator grant budget grids. Coordinates internal/external approvals and feedback to investigator grant budget grids and payment schedules. Provides support for escalations with external clients for investigator budget development, process and negotiation parameters. Provides approved investigator grant grids and payment schedules, process and negotiation parameters to local teams. Coordinates with internal departments to ensure various site startup activities are aligned with investigator grant activities and mutually agreed upon timelines; ensures alignment of investigator budget negotiation process for sites and study are properly aligned to the critical path for site activation. Adheres to PPD's target cycle times for site activations. Completes tracking and reporting as required. Job Complexity: Works on problems of limited scope. Follows standard practices and procedures in analyzing situations or data from which answers can be readily obtained. Job Knowledge: Learns to use professional concepts. Applies company policies and procedures to resolve routine issues. Supervision Received Normally receives detailed instructions on all work. Business Relationships: Contacts are primarily with immediate supervisor, and other personnel in the department. Builds stable working relationships internally. Qualifications: Education and Experience: Bachelor's degree or equivalent and relevant formal academic / vocational qualification Previous experience that provides the knowledge, skills, and abilities to perform the job (comparable to 0 to 2 years). In some cases an equivalency, consisting of a combination of appropriate education, training and/or directly related experience, will be considered sufficient for an individual to meet the requirements of the role. Knowledge, Skills and Abilities: Basic understanding of the principles of investigator grant template drafting Capable of reviewing and analyzing a protocol schedule of events to draft applicable budget grid and payment schedules therefrom Basic understanding of the pharmaceutical product development process and involvement of CROs Good oral and written communication skills Good attention to detail Good math skills Capable of working independently or in a team environment Good organizational and time management skills Proven flexibility and adaptability Basic proficiency with negotiation and conflict management Possesses cross cultural awareness and is able to adapt appropriately Good customer service skills, demonstrating a customer focused style of communication, problem solving and collaboration Basic experience with automated systems and computerized applications, such as, Microsoft Outlook, Excel, Word, etc Capable of acting independently and leading functional studies with general oversight Management Role: No management responsibility Working Conditions and Environment: Work is performed in an office/ laboratory and/or a clinical environment. Exposure to biological fluids with potential exposure to infectious organisms. Exposure to electrical office equipment. Personal protective equipment required such as protective eyewear, garments and gloves. Physical Requirements: Ability to work in an upright and /or stationary position for 6-8 hours per day. Repetitive hand movement of both hands with the ability to make fast, simple, repeated movements of the fingers, hands, and wrists. Frequent mobility required. Occasional crouching, stooping, with frequent bending and twisting of upper body and neck. Light to moderate lifting and carrying (or otherwise moves) objects including luggage and laptop computer with a maximum lift of 15-20 lbs. Ability to access and use a variety of computer software developed both in-house and off-the-shelf. Ability to communicate information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken words and sentences. Frequently interacts with others to obtain or relate information to diverse groups. Performs a wide range of variable tasks as dictated by variable demands and changing conditions with little predictability as to the occurrence. Ability to perform under stress. Ability to multi-task. Regular and consistent attendance. Salary Transparency: The salary range estimated for this position is $60,000 - $70,000. This position will also be eligible to receive a variable annual bonus based on company, team, and/or individual performance results in accordance with company policy. Actual compensation will be confirmed in writing at the time of offer. We offer a comprehensive Total Rewards package that our US colleagues and their families can count on, which generally include: • A choice of national medical and dental plans, and a national vision plan • A wellness program, and valuable health incentive opportunities for company contributions to a Health Reimbursement Accounts (HSAs) or Health Savings Account (HSA) •Tax-advantaged savings and spending accounts and commuter benefits • Employee assistance programs • At least 120 hours paid time off (PTO). 10 paid holidays annually, paid parental leave (3 weeks for bonding and 8 weeks for caregiver leave), accident and life insurance, short- and long-term disability, and volunteer rime off in accordance with company policy. • Retirement and savings programs, such as our competitive 401(k) U.S. retirement savings plan Accessibility/Disability Access: We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. EEO & Affirmative Action: Thermo Fisher Scientific is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, creed, religion, color, national or ethnic origin, citizenship, sex, sexual orientation, gender identity and expression, genetic information, veteran status, age or disability status.

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

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Flexible for any of our NC office locations (Must live in NC or within 40 miles of NC border) Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position will assist in the development, implementation, revision, maintenance, and promotion of the agency's fraud, waste, and abuse prevention and detection activities to ensure that the agency and the agency's network operates in a manner that complies with applicable State and Federal laws, regulations, agency policies, national accreditation, and Medicaid guidelines. This position will perform functions relating to data analysis, investigations, and auditing relating to the monitoring, detection, and resolution of healthcare fraud, waste, and abuse. Role and Responsibilities: Conduct, plan and perform independent and comprehensive audits, investigations and reviews (hereinafter referred to as investigations) into allegations of regulatory compliance violations, including fraud, waste, and abuse (FWA). Investigation includes the review of financial, consumer/clinical, provider, and/or other records, reports, and information necessary to thoroughly analyze and investigate suspected violations. Conduct clinical and non-clinical interviews, as necessary, to facilitate the investigative process. Work collaboratively with appropriate internal/external subject matter experts, agency and provider personnel, as necessary, to facilitate the investigative process. Conducts clinical chart reviews of instances of care authorized for utilization purposes, case reviews for individuals that are identified as either over or under-utilizers of services. Knowledge of documentation and clinical protocols for utilization purposes and case reviews for individual consumers in order to conduct clinical chart reviews. Clinical knowledge of managed systems of physical health services (professional and institutional), durable medical equipment, pharmacy, Mental Health, substance abuse, and Intellectual and Developmental Disabilities to also include co-occurring disorders. Knowledge of managed care practices and principles to detect fraud, waste and abuse. Clinical ability to recognize gaps in Partners Health Management service network and ability to communicate these identified gaps to appropriate parties. Serve as a Lead Investigator responsible for coordinating and leading agency investigative teams related to program integrity. Gather, evaluate, and synthesize evidence related to reported allegations to determine compliance with applicable state and federal policies, laws, and regulations. Prepare written and oral reports based on the results of assigned work that help to sustain findings and uphold disputed TNOs. Prepare timely, thorough, and accurate investigative reports; compile case file documentation; calculate overpayments; and synthesize findings in accordance with agency policies and procedures and departmental guidelines. Communicate effectively, both in writing and orally, to ensure accurate and timely completion of all assignments. Develop, implement, monitor, and maintain analytic reports to detect and prevent health care FWA. Conduct independent data mining and data analysis techniques utilizing claims data to detect abnormal claims and develop trends and patterns for potential cases. Independently prepare case documents for referral to the appropriate oversight agency and other external agencies involved in the prosecution of health care fraud. Manage cases from complaint intake through their ultimate conclusion, including supporting the case during all legal processes and appeals and the collection of final overpayments. Create, maintain, and manage cases within the case filing and tracking systems to ensure information is accurate, timely and complete. Consult with legal counsel in order to prepare testimony and other information necessary for appeals and as requested by external agencies investigating or prosecuting Medicaid fraud (as appropriate). Remain abreast of all federal and North Carolina rules and laws applicable to FWA and program integrity. Develop and conduct proactive audits, reviews and investigations of Partners' programs to facilitate the detection and resolution of FWA. Develop, coordinate, and facilitate educational training to the Provider Network and agency personnel on issues relating to the compliance program, FWA. Identify information system edits/alerts/reports in need of implementation in the claims processing system(s). Recommend and implement compliance initiatives, policies, procedures, and practices designed to promote and encourage the reporting of suspected FWA without fear of retaliation. Serve on and/or facilitate various agency committees as deemed necessary by the Program Integrity Director Use data collection instruments and protocols previously developed or adopted by the department and develop data collection instruments as needed for complex investigations. Analyze computer-generated data sets, including claims data, to identify individuals and organizations that are most likely to provide evidence to ascertain whether FWA is likely to have occurred. Develop summary reports that illustrate data analysis to a nonscientific audience. Use appropriate software and systems to complete work assignments. Consult with IT to manage data and generate needed program reports. Perform other duties as assigned. Knowledge, Skills and Abilities: Strong knowledge of state and federal laws, including those related to Medicaid FWA, and regulatory compliance are required. Knowledge of investigative methods and procedures. Knowledge of claims processing and clinical services. Excellent interpersonal and communication skills. Excellent analytical skills. Effective time management and organizational skills. Excellent conflict management skills. Proficient in Word, Excel, Outlook, and Power Point. Ability to learn and effectively manage various information systems including Partners' claims reporting and North Carolina TRACKS. Ability to develop solutions and make recommendations for necessary process improvements. Ability to interpret contractual agreements, business oriented statistics, clinical/administrative services and records. A high level of integrity and discretion is required to effectively carry out the responsibilities related to this position. Education and Experience Required: Master's degree in a Human Services field, Health Administration, health informatics/analytics, or related field, OR a Bachelor's of Science in Nursing and licensed to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing. Minimum of 3 years recent experience in the healthcare field with compliance monitoring, auditing or investigation experience. Licensed Clinical Social Worker, Licensed Clinical Mental Health Counselor, Licensed Clinical Addiction Specialist, Registered Nurse, Nurse Practitioner, Physician's Assistant, or another clinical license related to the healthcare field. Education and Experience Preferred: Five years recent experience in the healthcare field. Experience analyzing complex data, claims processing, utilization reviews, provider credentialing/monitoring, and/or fraud and abuse detection. Preferred credentials: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); Certified Fraud Examiner (CFE); and/or Accredited Healthcare Fraud Investigator (AHFI) certification. Licensure/Certification Requirements: Current unrestricted LCSW, LCMHC, LPA, LMFT or LCAS licensure with the appropriate professional board of licensure in the state of North Carolina or licensed to practice as a Registered Nurse, Nurse Practitioner in North Carolina by the N. C. Board of Nursing or licensure in the State of North Carolina or licensed to practice as a Physician's Assistant by the North Carolina Medical Board. Employee is responsible for complying with respective licensure board's continuing education/ training requirements in order to maintain an active license. Must maintain licensure or certification.

About Extend: Extend is revolutionizing the post-purchase experience for retailers and their customers by providing merchants with AI-driven solutions that enhance customer satisfaction and drive revenue growth. Our comprehensive platform offers automated customer service handling, seamless returns/exchange management, end-to-end automated fulfillment, and product protection and shipping protection alongside Extend's best-in-class fraud detection. By integrating leading-edge technology with exceptional customer service, Extend empowers businesses to build trust and loyalty among consumers while reducing costs and increasing profits. Today, Extend works with more than 1,000 leading merchant partners across industries, including fashion/apparel, cosmetics, furniture, jewelry, consumer electronics, auto parts, sports and fitness, and much more. Extend is backed by some of the most prominent technology investors in the industry, and our headquarters is in downtown San Francisco. About The Role The Fraud Intelligence team is the secret sauce behind Extend's post-purchase protection platform. We build cutting-edge analytics engines based on signals and transactions from hundreds of millions of users to detect and prevent fraud, drive smarter decisions, and unlock business value. We love uncovering beautiful patterns in messy data to catch bad actors and stop fraud in its tracks. You'll have the opportunity to shape new fraud prevention product features and analytics capabilities from the ground up. You'll work cross-functionally to develop go-to-market strategies based on your analysis. If you're data-obsessed, impact-driven, and excited to tackle complex problems at the intersection of analytics and fraud prevention, you'll thrive on our team. This is a high-ownership role where your work will directly protect retailers, enhance customer trust, and drive the company's bottom line! What You'll Be Doing Analyze large-scale behavioral, transactional, and interaction data to uncover signals indicative of fraud and abuse Apply strong business acumen to rapidly identify actionable insights, analyze fraud patterns, and validate hypotheses Influence business cases and pricing strategies, and contribute to proof-of-concept initiatives with prospective merchants Respond swiftly to emerging fraud threats by developing monitoring frameworks, dashboards, and mitigation solutions in collaboration with cross-functional teams Partner closely with leadership, go-to-market, fraud operations, product, and engineering teams to define and execute effective fraud strategies Champion a culture of continuous learning, experimentation, and collaboration across the fraud and broader data science teams What We're Looking For Hands-on, proactive, and analytical professional who is passionate about using data to solve complex, real-world problems 2+ years of experience in fraud analytics, ideally within an e-commerce or retail environment Prior experience in a startup or high-growth environment is preferred Bachelor's degree or higher in a quantitative field such as Mathematics, Statistics, Computer Science, Engineering, Operations Research, Physics or related field Strong grasp of core data science and analytics concepts, including statistical analysis, modeling, and data wrangling Proficiency in SQL and experience in Python (pandas, NumPy, scikit-learn, etc.) Exceptional communication and stakeholder management skills, with a proven ability to work cross-functionally and influence outcomes High attention to detail, strong intellectual curiosity, and a deep understanding of user behavior and fraud patterns Empathetic, humble, and collaborative team player Candidates must be located within the continental United States Expected Pay Range: $110,000 - $135,000 per year salaried* *The target base salary range for this position is listed above. Individual salaries are determined based on a number of factors including, but not limited to, job-related knowledge, skills and experience. Life at Extend: Working with a great team from diverse backgrounds in a collaborative and supportive environment. Competitive salary based on experience, with full medical and dental & vision benefits. Stock in an early-stage startup growing quickly. Generous, flexible paid time off policy. 401(k) with Financial Guidance from Morgan Stanley. Extend CCPA HR Notice