Senior Investigator remote jobs - 42 jobs

Handshake is recruiting Detectives and Criminal Investigator Professionals to contribute to an hourly, temporary AI research project-but there's no AI experience needed. In this program, you'll leverage your professional experience to evaluate what AI models produce in your field, assess content related to your field of work, and deliver clear, structured feedback that strengthens the model's understanding of your workplace tasks and language. The Handshake AI opportunity runs year-round, with project opportunities opening periodically across different areas of expertise. Details The position is remote and asynchronous; work independently from wherever you are. The hours are flexible, with no minimum commitment, but most average 5-20 hrs The work includes developing prompts for AI models that reflect your field, and then evaluating responses. You'll learn new skills and contribute to how AI is used in your field Your placement into a project will be dependent on project availability-if you apply now and can't work on this project, more will be available soon. Qualifications You have at least 4 years of professional experience in one or more of the following types of work. The examples below reflect the types of real-world responsibilities that you might have had in your role that will give you the context needed to evaluate and train high-quality AI models Conduct thorough investigations by collecting and analyzing evidence, interviewing witnesses and suspects, and documenting findings in detailed reports. Secure crime scenes, collaborate with other agencies, and prepare for court proceedings. Engage in surveillance and undercover operations, utilizing specialized equipment and techniques to gather critical information. You're able to participate in asynchronous work in partnership with leading AI labs. Application Process Create a Handshake account Upload your resume and verify your identity Get matched and onboarded into relevant projects Start working and earning Work authorization information F-1 students who are eligible for CPT or OPT may be eligible for projects on Handshake AI. Work with your Designated School Official to determine your eligibility. If your school requires a CPT course, Handshake AI may not meet your school's requirements. STEM OPT is not supported. For more information on what types of work authorizations are supported on Handshake AI.

Responsive recruiter KENTECH Consulting Inc. is an award-winning background technology screening company. We are the creators of innovative projects such as eKnowID.com, the first consumer background checking system of its kind, and ClarityIQ, a high-tech and high-touch investigative case management system. MISSION We're on a mission to help the world make clear and informed hiring decisions. VALUE In order to achieve our mission, our team embodies the core values aligned with it: Customer Focused: We are customer-focused and results-driven. Growth Minded: We believe in collaborative learning and industry best practices to deliver excellence. Fact Finders: We are passionate investigators for discovery and truth. Community and Employee Partnerships: We believe there is no greater power for transformation than delivering on what communities and employees care about. IMPACT As a small, agile company, we seek high performers who appreciate that their efforts will directly impact our customers and help shape the next evolution of background investigations. KENTECH Consulting Inc. is seeking a highly skilled and detail-oriented Background Investigator to conduct impartial, fact-based pre-employment investigations for municipal government agencies. This role requires strong investigative skills, excellent research abilities, and a commitment to maintaining accuracy and confidentiality. As a remote investigator, you will analyze applications, conduct interviews, research public records, and compile detailed reports. If you have a background in journalism, criminal investigations, or investigative reporting, this is an excellent opportunity to apply your skills in a fast-paced and high-impact environment. Key Responsibilities • Conduct pre-employment investigations on law enforcement and government candidates. • Research and analyze applications, employment records, criminal histories, and public records to verify candidate qualifications. • Conduct in-depth interviews through phone or virtual platforms to gather insights. • Execute criminal background checks and civil lawsuit verifications using public records. • Identify gaps or inconsistencies and determine the best approach to obtain accurate information. • Prepare comprehensive investigative reports with a high level of accuracy and clarity. • Maintain professional and timely communication with clients and agency stakeholders. • Organize information and manage caseloads efficiently to meet deadlines. Qualifications and Experience • College degree in Journalism, Criminal Justice, Political Science, Pre-Law, Paralegal, or a related field. • Five or more years of investigative or related experience, including journalism, investigative reporting, or criminal investigations. • Strong interviewing skills for both remote and in-person interviews. • Strong analytical and writing skills with the ability to interpret findings and deliver clear reports. • Proven ability to handle confidential information with professionalism and discretion. • Proficiency in Google Docs, Excel, and investigative tools or software. • Ability to pass a Security Clearance to obtain a Permanent Employee Registration Card (PERC) or already possess one. • Ability to complete a minimum of five cases per week. Key Soft Skills • Attention to detail with a focus on accuracy and clarity. • Ethical integrity and the ability to conduct unbiased investigations. • Clear and professional communication across interviews, reporting, and client interactions. • Strong investigative mindset with the ability to identify gaps and analyze findings. • Effective time management and the ability to handle multiple cases while meeting deadlines. Compensation and Benefits • 1099: 200 dollars per case. Apply Now If you are a meticulous investigator with a strong analytical mindset, we would love to hear from you. KENTECH Consulting Inc. is an equal opportunity employer. We celebrate diversity and remain committed to fostering an inclusive workplace. This is a remote position. Compensation: $200.00 per day We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. 🌐 WHO WE ARE KENTECH Consulting, Inc. is a premier U.S.-based background investigation solutions firm and licensed Private Detective Agency. Our team of investigative experts blends cutting-edge technology with industry insight to deliver fast, accurate, and comprehensive reports. With deep cross-industry experience, we provide fully compliant investigative services that meet the high demands of today's business environment. 🔎 WHAT WE DO We offer customized background screening solutions tailored to meet the needs of diverse industries. Our advanced tools and digital platforms allow us to conduct background and security checks up to 75% faster than traditional methods. With real-time access to over 500 million records, KENTECH is a trusted authority in background checking technology across the U.S. 🌟 OUR VISION To help the world make clear and informed decisions. 🎯 OUR MISSION To deliver fast, accurate, and secure background investigations on a global scale-supporting safer hiring decisions and stronger communities. 🚀 CAREERS AT KENTECH We're building a team of remarkable individuals who are: ✅ Critical thinkers and problem solvers who see challenges as opportunities ✅ Driven professionals who create meaningful impact through their ideas and results ✅ Mission-driven collaborators who believe in the power of digital identity to create safer environments ✅ Naturally curious and eager to innovate in an ever-changing landscape ✅ Team players who believe in the value of camaraderie, laughter, and high standards 💼 WHO THRIVES HERE? People who never back down from a tough challenge Professionals who bring their best every day-and uplift others around them Individuals who value purpose, performance, and a good laugh Teammates who want to shape the future of digital security and identification You, if you're reading this and thinking: “This sounds like my kind of place.” 🎉 YOUR NEXT CHAPTER STARTS HERE Ready to do work that matters with people who care? Explore our current openings-your future team is waiting.

Successfully completes high-quality, sophisticated long term care claims investigations Independently develops and drives a detailed investigative plan Acquires and reviews internal / external documents to support investigative activity and findings Conducts interviews of insureds, caregivers, and other involved parties Handles third party vendor(s) conducting long term care surveillance activities Regularly communicates findings and investigation status to Requesters Produces reports that are accurate and objective Presents case findings and recommendations for further action to department management and Requesters Optimally applies internal case management systems to keep department management updated and to plan / prioritize concurrent assignments Adheres to departmental, company and regulatory timelines, policies, and requirements When applicable, prepares and presents cases for referral to law enforcement, prosecutors, and regulators; provides depositions, grand jury, and court testimony as the need arises Mentors and trains more junior investigators on long term care claim cases and processes Ability to travel on short notice and responds to urgent long term care claim investigations Maintains knowledge of sophisticated investigative techniques, company / external sources of information, changes in the financial services industry as well as applicable laws and regulations impacting long term care claim investigations and other relevant topics Maintains and continuously expands network of professional contacts Plays a major role in the department's fraud awareness training program by developing and delivering appropriate material to employees Attends training sessions, reads pertinent trade journals, actively participates in, and makes presentations to professional organizations and associations Required Qualifications: Bachelor's degree preferably in Criminal Justice or related field required; graduate work a plus 5+ years of proven track record in the investigation profession and/or financial services industry Designations / certifications in relevant subject matter areas a plus (CFE, LTCP, LOMA) Preferred Qualifications: Highly proficient in various computer applications (Microsoft products etc.) Sophisticated written and verbal communication skills Sophisticated analytical skills Sophisticated interviewing skills Ability to work in a dynamic environment Efficient and effective organizational skills Strong presentation skills Foreign language proficiency a plus When you join our team: We'll empower you to learn and grow the career you want. We'll recognize and support you in a flexible environment where well-being and inclusion are more than just words. As part of our global team, we'll support you in shaping the future you want to see. #LI-Remote #LI-JH About Manulife and John Hancock Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit ************************************************* Manulife is an Equal Opportunity Employer At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law. It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact ************************. Referenced Salary Location USA, Florida - Full Time Remote Working Arrangement Remote Salary range is expected to be between $88,200.00 USD - $152,880.00 USD If you are applying for this role outside of the primary location, please contact ************************ for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance. Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence. Know Your Rights I Family & Medical Leave I Employee Polygraph Protection I Right to Work I E-Verify Company: John Hancock Life Insurance Company (U.S.A.)

The Special Investigation Unit (SIU) is a motivated, collaborative team sitting at the intersection of Compliance, Payment Integrity, and Data Infrastructure. The SIU ensures that Clover monitors, identifies and investigates instances of healthcare fraud, waste and abuse (FWA). Come join us as we discover new opportunities to enhance the fight against FWA! As the Senior Investigator, you will play a critical role ensuring that Clover is able to continue to build and scale a compliant, effective FWA audit program. You will work to ensure quality assurance standards and regulatory policy are reflected in our audit practices. You will be joining a fast-growing and fast-moving startup at the intersection of healthcare and technology, where you will have the opportunity to develop both your policy and operational skills. A successful Senior Investigator will have a robust FWA knowledge base and be able to develop, document and execute an effective and efficient FWA audit strategy to identify, audit, track, and report on known or suspected instances of FWA. As a Senior Investigator, you will: Lead development and execution of SIU process improvements to improve the effectiveness and efficiency of our SIU audit processes Identify control opportunities to mitigate FWA Identify possible audit opportunities Implement an effective audit strategy to investigate known or suspected instances of FWA Support annual FWA audit goals Support complex provider conversations around FWA audit findings Prepare response letters to deliver decisions to providers within the regulatory timeframes set forth by the Centers for Medicare & Medicaid Services (CMS). Manage overall audit workload to ensure timely and accurate audit results Act as a FWA subject matter expert Mentor other team members on audit strategies Build strong working relationships with both regulatory and law enforcement agencies, and Communicate effectively while building trust and lasting partnerships both laterally and vertically across multi-discipline teams. Success in this role looks like: By the end of your initial 90 day period, you will have demonstrated a strong understanding of our SIU case flow and are able to effectively navigate through the various Clover systems. By 6 months, you will be working autonomously on cases and provider reviews. Continued success in this position anchors in on developing a deep understanding of the workflows that support our SIU cases and reviews while maintaining regulatory compliance standards. You should get in touch if: You have 5+ years of experience in the healthcare FWA space. You have experience identifying operations and process improvement efforts. You have an understanding of compliance & payer requirements including Medicare regulations. You have knowledge on fraud statutes and regulations You have a Fraud Investigation Certification (CFE, AHFI, etc.) - preferred but not required. Benefits Overview: Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions. Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare. Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews. Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities Reimbursement for office setup expenses Monthly cell phone & internet stipend Remote-first culture, enabling collaboration with global teams Paid parental leave for all new parents And much more! About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most. We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare. From Clover's inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity. All of our employee's points of view are key to our success, and inclusion is everyone's responsibility. #LI-REMOTE Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company. A reasonable estimate of the base salary range for this role is $104,000 to $127,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc. #LI-Remote

Successfully completes high-quality, sophisticated long term care claims investigations Independently develops and drives a detailed investigative plan Acquires and reviews internal / external documents to support investigative activity and findings Conducts interviews of insureds, caregivers, and other involved parties Handles third party vendor(s) conducting long term care surveillance activities Regularly communicates findings and investigation status to Requesters Produces reports that are accurate and objective Presents case findings and recommendations for further action to department management and Requesters Optimally applies internal case management systems to keep department management updated and to plan / prioritize concurrent assignments Adheres to departmental, company and regulatory timelines, policies, and requirements When applicable, prepares and presents cases for referral to law enforcement, prosecutors, and regulators; provides depositions, grand jury, and court testimony as the need arises Mentors and trains more junior investigators on long term care claim cases and processes Ability to travel on short notice and responds to urgent long term care claim investigations Maintains knowledge of sophisticated investigative techniques, company / external sources of information, changes in the financial services industry as well as applicable laws and regulations impacting long term care claim investigations and other relevant topics Maintains and continuously expands network of professional contacts Plays a major role in the department's fraud awareness training program by developing and delivering appropriate material to employees Attends training sessions, reads pertinent trade journals, actively participates in, and makes presentations to professional organizations and associations Required Qualifications: Bachelor's degree preferably in Criminal Justice or related field required; graduate work a plus 5+ years of proven track record in the investigation profession and/or financial services industry Designations / certifications in relevant subject matter areas a plus (CFE, LTCP, LOMA) Preferred Qualifications: Highly proficient in various computer applications (Microsoft products etc.) Sophisticated written and verbal communication skills Sophisticated analytical skills Sophisticated interviewing skills Ability to work in a dynamic environment Efficient and effective organizational skills Strong presentation skills Foreign language proficiency a plus When you join our team: We'll empower you to learn and grow the career you want. We'll recognize and support you in a flexible environment where well-being and inclusion are more than just words. As part of our global team, we'll support you in shaping the future you want to see. #LI-Remote #LI-JH About Manulife and John Hancock Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit ************************************************* Manulife is an Equal Opportunity Employer At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law. It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact ************************. Referenced Salary Location USA, Florida - Full Time Remote Working Arrangement Remote Salary range is expected to be between $88,200.00 USD - $152,880.00 USD If you are applying for this role outside of the primary location, please contact ************************ for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance. Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence. Know Your Rights I Family & Medical Leave I Employee Polygraph Protection I Right to Work I E-Verify Company: John Hancock Life Insurance Company (U.S.A.)

Integrity Management Services, Inc. (IntegrityM) is a woman-owned small business specializing in assisting government healthcare organizations prevent and detect fraud and abuse in their programs. At IntegrityM, we offer a culture of opportunity, recognition, and collaboration. We thrive off of these fundamental elements that make IntegrityM a great place to work. We offer the flexibility our employees need to challenge themselves and focus on advancing their professional development and careers. Large company perks. Small company feel. ****************** In this role, the Marketplace Senior Investigator will provide investigative services to safeguard the integrity of the health insurance Marketplace authorized by the Affordable Care Act (ACA). The Marketplace Senior Investigator will use a variety of tools to initiate investigations, identify subjects and develop cases for future action, including a referral to law enforcement, education, over payment recovery and other administrative actions that follow the Marketplace rules, requirements and laws. The Marketplace Senior Investigator works independently as well as collaboratively with various team members and managers. Job Responsibilities: Conducts background research of suspect agents/brokers to identify information regarding adverse business relationships, disqualifying violations, exclusions or licensing sanctions. Conducts data analysis to identify instances of suspected healthcare fraud, waste, and abuse. Identify data anomalies that lead to new project priorities. Reviews policies, regulations and instructions relevant to supporting suspected healthcare fraud, waste and abuse violations and provides that information as necessary in support of data analysis findings. Documents all findings relevant to support recommendations for further analysis or investigation referrals. Analyze and evaluate enrollment data related to consumer and Agent/Broker activity within the Marketplace. Collects and reviews records and documents relevant to investigation development. Conducts interviews and maintains accountability and safeguards any items considered to be of evidentiary value in accordance with established guidelines and rules of evidence. Coordinates investigations with appropriate federal and state law enforcement agencies, legal counsel and state and federal program administration agencies. Coordinates within a team of ACA policy subject matter experts (SMEs), data analysts, program managers, and other staff as appropriate to develop or unfound investigations. Inputs data into appropriate database tracking programs as needed in accordance with established rules. Coordinates with clients in support of findings and recommendations resulting from investigations and data analysis. Provides input into development of new fraud scheme studies. Actively supports preparation of comprehensive reports on the status of leads and investigations as required by CMS. Meets all established deadlines. Works with internal resources and external agencies to develop cases and corrective actions, as well as responds to requests for data and support. Maintains fraud case development quality standards so that proper case development is ensured and quality cases are fully prepared. Maintains proper and timely updates in appropriate tools and applications for their investigations. Case development databases and documents. Completes all requests for information from law enforcement within required timeframes. Enhances fraud detection and improves interdepartmental workflow so that it is evident the client is being proactive in its efforts to identify potentially fraudulent schemes. Conducts on-site visits and/or interviews as required for investigation. Performs ad hoc tasks/duties as assigned. Ensures compliance with all applicable privacy and security training requirements (both IntegrityM and external/client-based), whether on an annual or ad/hoc basis. Please note: certain position levels (leads, managers, directors or higher) may require additional “role-based” training to ensure compliance with applicable privacy and security requirements. Exercises appropriate discretion and independent judgment relating to company policies and practices in an effective, consistent and professional manner. Adheres to applicable policies ensuring commitment to quality, compliance and security to protect the confidentiality, integrity, and availability of sensitive data and information. Adheres to all IntegrityM and/or client privacy and security protocols governing sensitive and/or business confidential information. Requirements Job Qualifications: Bachelor degree (e.g., law enforcement investigation, statistics, data analysis) or equivalency in healthcare field that includes 2-4 years' ACA and/or Medicare and Medicaid experience. 2 or more years' experience with and/or understanding of ACA policies and regulations related to consumer enrollments requirements and Agent/Broker and Navigator responsibilities. Experience with FWA claims and investigations preferred. Strong investigative skills Strong communication and organization skills Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases. Experience reviewing complex data reports. Strong oral and written communication skills, strong interpersonal skills, and superior organizational abilities. · Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) a plus (and or may be required). Ability to take initiative, to maintain confidentiality, to meet deadlines, and to work in a team environment. Ability to report work activity on a timely basis. Ability to work independently and as a member of a team to deliver high quality work. Ability to multitask and prioritize assignments while meeting deadlines. · Proficiency in Microsoft Office, specifically Microsoft Word and Excel. · Passion and alignment with IntegrityM's mission, vision, values and operating principles. Additional Requirements: · Must pass post hire background screening checks. · For remote work, required to have wired and/or wireless internet access. · Ability to obtain security clearance, if required by Client/Contract.

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at ********************************* Position Overview: The Special Investigations Unit (SIU) Coder supports lines of business from McLaren Health Plan, Inc., McLaren Health Plan Community, and McLaren Health Advantage (McLaren) and is responsible for performing medical claims and records reviews to assist in investigations, ensuring compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The SIU Coder works in collaboration with a team of SIU Auditors to review records and claims as part of the ongoing audits of the SIU department. The SIU Coder serves as the subject matter expert for all coding activities and collaborates with other departments within McLaren on payment integrity and provider education. This position is fully remote. Qualifications: Required: * Associate's Degree in Health Information Management, Healthcare Business Services, or equivalent program with emphasis in coding or High School diploma with two (2) years of related experience. * Certified Medical Coder (CPC, RHIT, or RHIA). * Two (2) years of hands-on experience in ICD-10-CM and AMA diagnostic coding (with a preference for program integrity coding) and ICD-10 and AMA coding guidelines with the ability to interpret complex medical documentation accurately. * Two (2) years of coding experience on multiple specialties. Preferred: * Five (5) years coding and/or coding and billing experience. * Two (2) years' experience assisting with SIU audits. * Managed Care experience. Additional Information * Schedule: Full-time * Requisition ID: 26000572 * Daily Work Times: 8:30 am - 5:00 pm * Hours Per Pay Period: 80 * On Call: No * Weekends: No

SIU Investigator - CF08BE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our team as we help shape the future. We are seeking a talented Special Investigator to join our Special Investigations Unit (SIU). This position will be based out of the Richmond, VA area. The coverage territory will be all of VA and Northern North Carolina. The ideal candidate for this opportunity will spend 100% of their time traveling within their assigned region to visit loss sites, interview witnesses, conduct recorded statements, take photos, and inspect physical evidence. Additionally, the candidate will investigate all lines of business to include Medical Investigations in Auto, Worker's Compensation, General Liability and Group Benefits as well as Property losses. SIU Investigators work in partnership with claim handlers across all lines of business to investigate suspicious claims. The Field Investigators performing investigations to provide information to the claims handler which will assist in the adjudication of the claim. The mission of the SIU is to contribute to claims accuracy by building fraud awareness and investigating questionable claims. This position will report to the SIU Manager and will be responsible for conducting thorough, timely, efficient and impartial investigations to support the accurate resolution of insurance claims by the Company. Key responsibilities of the role include: • This SIU Investigator will be responsible for assignments in Virginia and the Northern North Carolina areas. • Assignments may include investigations directly referred by the claim staff, or losses reviewed by the field investigator proactively which may be appropriate for SIU Involvement. • The investigator is expected to have face to face interaction with parties to a loss, including insured, claimants, witnesses, experts, and other professionals on a routine basis. • Excellent interpersonal, communication and interview skills are required. • Investigative assignments may include claims with identified suspicious loss indictors, definable inconsistencies, or those which otherwise require a high-level investigative skill and/or local in person presence. • Effective time management skills, proactive execution of investigative plans, and flexibility are necessary to ensure the effectiveness of this position. • The investigator must understand and exhibit appropriate investigative behaviors and methods while conducting investigations, including development of the facts, due diligence around evidence collection and interviews. • The Investigator must be able to effectively communicate investigative findings orally and in writing. • The Investigator will also be responsible for understanding fraud trends within his or her area of responsibility and leverage knowledge gained to SIU analytical resources. • Independently complete investigations in accordance with The Hartford's core performance values and best practices with minimal direction. • Prepare and submit investigative reports detailing and documenting all phases of an investigation to assist in the resolution of the claim. • Recognize intelligence opportunities through active investigations and shares this information within SIU. • Interface with the SIU Community and Law Enforcement; including attendance of NICB and other industry meetings. • Continually enhance investigative skills and understanding of emerging issues impacting property and casualty and group benefit claims. • Provide support to claims partners and other departments within the • Company, which may include identifying training needs; participation in developing and presenting training and mentoring of external business partners and internal staff. QUALIFICATIONS: • Bachelor's Degree preferred. • Minimum of 3 years special investigation insurance experience and/or investigative law enforcement experience required. • Reside roughly within 30 miles of Richmond, VA to cover Virginia and Northern North Carolina. • Solid understanding of SIU or relevant claim processes, practices, and applicable laws and regulations strongly preferred. • Designations in CIFI, FCLS or FCLA are strongly preferred. • Strong interviewing and communication skills (verbal and written). • The ability to work well independently and in a team environment. • Consistent high level of performance and achievement over career span. • Strong critical thinking and analytical skills; ability to make deductions; logical and sequential thinker. • Excellent written and verbal communication and diplomacy skills, inspiring confidence among main customers. • The ability to work well independently and in a team environment. • Consistent high level of performance and achievement over career span. WHAT ELSE CAN YOU TELL ME? • The SIU Investigator is a remote position and will require 100% travel within the assigned territory. The Special Investigator for this opportunity will be based out of the Richmond , VA area. • A cell phone and a wireless laptop is provided for this opportunity. A company car will be provided, and a valid driver's license is required. Compensation The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford's total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is: $87,200 - $130,800 Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age About Us | Our Culture | What It's Like to Work Here | Perks & Benefits

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.

Our roster has an opening with your name on it This role is responsible for leading and conducting comprehensive, complex investigations related to regulator concerns related to deposit fraud, play integrity, abuse, account takeovers, organized fraud, and other fraud specific investigations. This position will be a part of internal quality assurance testing as it relates to fraud processes along with preparing and presenting findings. This role is required to stay current on fraud trends and emerging threats and present case studies to the broader team on a recurring basis. As a Fraud Investigative Lead Supervisor, you will be contributing to state-specific reporting and regulatory-related fraud reviews. In addition to completing and leading investigations, this role will be responsible for overseeing direct reports, and managing tasks such as coordinating job rotations, providing regular and consistent feedback to direct reports, reporting significant findings and activity updates to the Fraud investigative Manager, goal coaching, and other supervisory tasks. This role may assist in designing, documenting, implementing, and monitoring of new procedures/services. Candidates for this role must pass the required licensing as mandated by various state gaming and racing regulatory bodies. Failure to be licensed or retain licensure will result in termination of employment. This position reports to the Fraud Investigative Manager. In addition to the specific responsibilities outlined above, employees may be required to perform other such duties as assigned by the Company. This ensures operational flexibility and allows the Company to meet evolving business needs. THE GAME PLAN Everyone on our team has a part to play Train and mentor Fraud Investigators and Fraud Prevention Analysts within our department Participate in quality assurance testing related to fraud prevention efforts Prepare investigation reports, summaries, and present findings Investigate and research allegations of fraud or abuse of system controls and communicate root cause findings Lead applicable state-specific regulatory fraud form reporting and regulator investigations Research, evaluate, and analyze information and intelligence to determine risk Aid in developing fraud mitigation strategies OSINT collection and analysis Collaborate with other departments within our organization, such as Security, Risk, Compliance, and other related teams Analyze past and current fraud trends and suspicious behavior tracking Continually learn and adapt to changing fraud trends and behavior Other tasks and projects as assigned by the leadership team THE STATS What we're looking for in our next teammate 3+ years of fraud experience in daily fantasy sports, online gaming or related industries 1+ years of leadership experience preferred Proficiency with SQL required Experience with digital payments and understanding of e-Commerce platforms Cybersecurity experience a plus Experience interacting with regulators and compliance a plus Prior experience using open-source intelligence Strong verbal and written communication skills Bachelor's degree in related field preferred Demonstrated aptitude for process execution, including identification of areas for improvement In-depth knowledge and understanding of common fraud trends and emerging threats Advanced knowledge of common fraud prevention strategies and systems Intermediate understanding of Check, ACH, Wire, Debit/Credit card, PayPal and other payment channel operating rules Effective communication, organizational, problem-solving, and analytical skills Passion for sports and/or gaming industry a plus Licensure: Must be able to pass required licensing as mandated by various state racing and gaming regulatory bodies ABOUT FANDUEL FanDuel Group is the premier mobile gaming company in the United States and Canada. FanDuel Group consists of a portfolio of leading brands across mobile wagering including: America's #1 Sportsbook, FanDuel Sportsbook; its leading iGaming platform, FanDuel Casino; the industry's unquestioned leader in horse racing and advance-deposit wagering, FanDuel Racing; and its daily fantasy sports product. In addition, FanDuel Group operates FanDuel TV, its broadly distributed linear cable television network and FanDuel TV+, its leading direct-to-consumer OTT platform. FanDuel Group has a presence across all 50 states, Canada, and Puerto Rico. The company is based in New York with US offices in Los Angeles, Atlanta, and Jersey City, as well as global offices in Canada and Scotland. The company's affiliates have offices worldwide, including in Ireland, Portugal, Romania, and Australia. FanDuel Group is a subsidiary of Flutter Entertainment, the world's largest sports betting and gaming operator with a portfolio of globally recognized brands and traded on the New York Stock Exchange (NYSE: FLUT). PLAYER BENEFITS We treat our team right We offer amazing benefits above and beyond the basics. We have an array of health plans to choose from (some as low as $0 per paycheck) that include programs for fertility and family planning, mental health support, and fitness benefits. We offer generous paid time off (PTO & sick leave), annual bonus and long-term incentive opportunities (based on performance), 401k with up to a 5% match, commuter benefits, pet insurance, and more - check out all our benefits here: FanDuel Total Rewards. *Benefits differ across location, role, and level. FanDuel is an equal opportunities employer and we believe, as one of our principles states, “We are One Team!”. As such, we are committed to equal employment opportunity regardless of race, color, ethnicity, ancestry, religion, creed, sex, national origin, sexual orientation, age, citizenship status, marital status, disability, gender identity, gender expression, veteran status, or any other characteristic protected by state, local or federal law. We believe FanDuel is strongest and best able to compete if all employees feel valued, respected, and included. FanDuel is committed to providing reasonable accommodations for qualified individuals with disabilities. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please email ********************. The applicable salary range for this position is $78,000 - $97,000 USD, which is dependent on a variety of factors including relevant experience, location, business needs and market demand. This role may offer the following benefits: medical, vision, and dental insurance; life insurance; disability insurance; a 401(k) matching program; among other employee benefits. This role may also be eligible for short-term or long-term incentive compensation, including, but not limited to, cash bonuses and stock program participation. This role includes paid personal time off and 14 paid company holidays. FanDuel offers paid sick time in accordance with all applicable state and federal laws. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. #LI-Hybrid

Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a Fraud Investigator Admin Action Specialist to our SGS team of talented professionals. The Fraud Investigator Admin Action Specialist is responsible for being a Point of Contact for Investigations, MAC and CMS regarding all administrative actions related to investigations. Review and verify evidence supporting an administrative action as it relates to payment suspensions, revocations, overpayments as well as other administrative actions that can be pursued. Work with the Investigations, Medical Review and Data teams to ensure that the documentation gathered is sufficient to support an administrative action. Making administrative action recommendation to Investigations and CMS. Work with CMS, law enforcement and the Medicare Administrative Contractor throughout the life of the action. Monitor workload to ensure all actions are taken within the required timeframes set forth in the Program Integrity Manual. Prepare and submit administrative action packages to CMS and the MACs for approval and processing and speak to the action development. Ensure that all timelines are followed. Telework available from any location but must be available during eastern time zone hours. Qualifications Basic Qualifications: 4 years with AS/AA; 2 years with BS/BA; 0 years with MS/MA; 6 years with High School diploma/equivalent in lieu degree Knowledge of Medicare requirements, laws, rules and regulations related to payment for services billed to the Program Strong critical thinking, communication, writing and organizational skills Experience in developing fraud cases Strong PC knowledge and skills Knowledge of Medicare systems Ability to perform research and draw conclusions Ability to present issues of concern, citing and interpreting regulatory violations Ability to organize a case file, accurately and thoroughly document all steps taken Ability to compose correspondence, reports and letters clearly and concisely. Ability to communicate effectively, internally and externally Ability to interpret laws and regulations Ability to handle confidential material Ability to report work activity on a timely basis Ability to work independently and as a member of a team to deliver high quality work Ability to attend meetings, training, and conferences, overnight travel may be required US citizenship required Desirable Qualifications: The most competitive candidates will have: Medicare fraud investigation and/or Medicare billing background Investigation CFE or AHFI certification Peraton Overview Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure. Target Salary Range $51,000 - $82,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay. EEO EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.

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

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

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!

The Field Investigator (FI) directly supports national security and suitability investigations, focusing on performing background investigations on behalf of government clients. Investigators will conduct interviews, retrieve records, conduct research, and prepare reports of investigations in compliance with federal standards, all laws, and other required federal agency regulations. Investigators type comprehensive reports summarizing facts obtained from these field source interviews and record information, and submit them for quality review and completeness. Casework is performed throughout the geographic area of responsibility with travel to various places of employment, residence, and education institutions. Travel to other geographic locations (by car or by plane) may also be required as needed. ESSENTIAL FUNCTIONS The functions listed describe the business purpose of this job. Specific duties or tasks may vary and be documented separately. The employee might not be required to perform all functions listed. Additional duties may be assigned, and functions may be modified according to business necessity. All assigned duties or tasks are deemed to be part of the essential functions unless such duties or tasks are unrelated to the functions listed, in which case they are deemed to be other (non-essential) functions. Employees are held accountable for successful job performance. Job performance standards may be documented separately and may include functions, objectives, duties, or tasks not specifically listed herein. In performing functions, duties, or tasks, employees are required to know and follow safe work practices and to be aware of company policies and procedures related to job safety, including safety rules and regulations. Employees are required to notify superiors upon becoming aware of unsafe working conditions. All functions, duties, or tasks are to be carried out honestly, ethically, and professionally and are to be performed in conformance with applicable company policies and procedures. In the event of uncertainty or lack of knowledge of company policies and procedures, employees are required to request clarification or explanations from superiors or authorized company representatives. Conduct interviews and background checks that help to ensure the safety and security of the nation. Obtain and report factual information for background investigations that determine employment suitability and security clearance eligibility. Conduct face-to-face interviews with the applicant and their neighbors, coworkers, friends, and associates. Complete record searches at law enforcement agencies, courthouses, and mental health, financial, and educational institutions. Compile information in a clear, concise report on a standardized reporting format. Meet quality, timeliness, and production metrics Interact with team leader and case review officers to ensure timeliness and thoroughness of investigations. Assist in obtaining fieldwork in a rapid, time-sensitive work environment. Ensure leads are completed in a timely manner and in accordance with investigative standards. May be asked to assist with temporary details (TDYs) to high-need areas, dependent upon workload demands. Perform additional functions, duties, and specific tasks of a similar nature and scope as necessary to achieve assigned business objectives. MINIMUM QUALIFICATIONS AT ENTRY Additional qualifications may be specified and receive preference depending upon the nature of the position. Basic Qualifications Must be a citizen of the United States. At least 18 years of age. Ability to acquire and maintain the required level of U.S. Government security clearance. Must be able to complete and pass all required training successfully. Ability to acquire and maintain any other specific special clearances/access requirements and successfully pass an adjudicated SSBI clearance. Reliable personal vehicle, valid driver's license, and satisfactory driving record. Familiarity with metrics tools, processes, and delivery assurance. Strong interpersonal, writing, and communications skills. Ability to cover a local territory of approximately a 50-mile radius from home residence. Must have the ability to travel 100% of the time with coverage area that consists of assigned geography. Will require vehicle travel and may require air, train, or other commercial travel methods. Education/Experience Bachelors Degree or equivalent is required; additional relevant experience can be substituted for the required education on the basis of one (1) calendar year of experience for one (1) academic year of education. Prior background investigations, law enforcement, or personnel security experience is preferred but not required. Background Prerequisites Must undergo and meet company standards for background and reference checks, controlled substance testing, and behavioral selection survey, in addition to any mandatory licensing requirements. Competencies (as demonstrated through experience, training, and/or testing) Ability to work remotely without daily supervision. Intermediate typing and computer skills. Excellent time management and organizational skills to balance and prioritize work. Ability to handle multiple tasks concurrently. Interpersonal skills to interact with sources, customers, and team members. Ability to establish and build rapport with new people. Speak and hear sufficiently to communicate in person and by phone. Excellent written and verbal communication skills. Visual ability to include close vision, distance vision, and ability to adjust focus. Personal computer and business solutions software skills. Ability to identify, understand, and apply federal, state, and local changes and/or new regulations/laws pertaining to personnel investigations. Ability to work in a team environment. Analytical and problem-solving skills. Ability to synthesize information, identify key findings, and determine conclusions. WORKING CONDITIONS (Physical/Mental Demands) With or without reasonable accommodation, requires the physical and mental capacity to perform effectively all essential functions. In addition to other demands, the demands of the job include: Maintaining composure in dealing with executives, sources, subjects, and staff, in group and one-on-one settings and in situations requiring high performance and results. Handling and being exposed to sensitive and confidential information. Frequent sitting, standing, and walking, which may be required for long periods of time and may involve climbing stairs and walking up inclines and on uneven terrain. Occasional lifting and/or moving up to 10 pounds. Regular use of vehicle required in the performance of duties. Frequent local travel to interview sites. Speak and hear sufficiently to communicate in person and by phone. Maintain visual ability, including close vision, distance vision, and ability to adjust focus. BENEFITS - Wage range for this position is $24.24 - $41.33 with a Health and Welfare benefit of $4.60 per hour (up to a maximum of 40 hours per week). Benefits: Medical, Dental, Vision, 401k (if paid via Health and Welfare benefit, there is no separate company contribution) The paid leave for full time employees is as follows: Vacation 80 hours annually. This time increases based on years of service with the company. Sick 56 hours annually Floating Holidays 32 hours annually

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/RSUs), 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

Fraud Analytics Lead Talent Community FinTrust Connect United States Remote For more Job Opportunities follow FINTRUST CONNECT here FinTrust Connect on LinkedIn Share Your Resume and Build Your Future! We are thrilled to invite you to join our exclusive Talent Community. Are you looking for your next career opportunity Look no further. Join our Talent Network today. By sharing your resume with us, you will be added to our database and considered for future roles with leading banks and fintechs. Whether you prefer flexible work arrangements, remote opportunities, or on site environments, we have options for you. Take the first step toward a brighter future. Share your resume with us today. As a Fraud Analytics Lead you will design rules and machine learning strategies that lower losses without hurting good customer approvals. You will tune controls across account opening and payments and card and ACH and real time rails and partner with operations to move fast on emerging patterns. Requirements 7 to 10 years in fraud analytics for a bank or fintech with measurable loss reductions Hands on rule and model tuning in one or more platforms Feedzai NICE Actimize IFM SAS Fraud Sift Forter Kount ThreatMetrix Ekata Riskified Stripe Radar Strong SQL and Python and experience with feature stores and real time scoring Kafka or Kinesis and Spark or Flink Knowledge of RTP and FedNow and ACH and card fraud patterns and first party and third party and mule activity Experience with step up controls device and behavior signals velocity limits MFA and SCA Familiarity with Reg E and network dispute flows and chargeback life cycle Clear documentation and dashboards for executives and auditors Responsibilities Own fraud strategy across the funnel identity proofing account creation login payment dispute Build and maintain rule sets and ML models and scorecards run A B tests and champion challenger designs Engineer high signal features device fingerprint geovelocity merchant and counterparty risk historical exposure Monitor loss and approval and false positive tradeoffs daily adjust thresholds with safe guards Partner with operations on playbooks and queues and investigator feedback loops Lead rapid response to fraud spikes and scams and mule rings with clear comms and actions Produce evidence and reporting for regulators and networks and audit Coach analysts and evolve documentation and runbooks Outcomes we track Fraud loss rate reduced 20% to 40% in 90 days with approval rate stable or better Chargebacks reduced 20% with recovery rate improved Precision and recall within policy bands with documented before and after Alert aging over 2 business days under 5% Documentation completeness at 100% with reproducible queries and code Compensation and terms Consultant pay $50 to $120 per hour based on rail coverage and tool depth Contract Remote US W2 or 1099 Multiple openings for a national bench and pod builds How to apply Apply on our site FinTrust Careers Prefer email send your resume to ************************** with subject [Apply] Fraud Analytics Lead Remote US Stay in the loop follow FinTrust Connect on LinkedIn and our social channels FinTrust Connect is an equal opportunity employer. Keywords Fraud Analytics, Fraud Strategy, First Party Fraud, Third Party Fraud, Account Opening, Account Takeover, Money Mule, Bust Out, Transaction Fraud, RTP, FedNow, ACH, Card Fraud, Chargebacks, Disputes, Unauthorized Returns, Device Intelligence, Behavioral Biometrics, Velocity Rules, Step Up Authentication, MFA, SCA, Rules Engine, Machine Learning, Scorecards, Feature Store, Real time Scoring, Kafka, Kinesis, Spark, Flink, SQL, Python, Feedzai, NICE Actimize IFM, SAS Fraud, Sift, Forter, Kount, ThreatMetrix, Ekata, Riskified, Stripe Radar, Precision, Recall, False Positive Rate, Alert Aging, Loss Analytics, Dashboarding, Examiner Evidence, Reg E, UCC 4A, PCI DSS, Remote

Job Title: Healthcare Fraud Investigator Employer: Cameo Consulting Group, LLC Contract Type: Full-Time, Contract Position Clearance Required: Must be able to obtain and maintain required DOJ security clearance Travel: Occasional local and out-of-district travel may be required Job Summary Cameo Consulting Group, LLC is seeking an experienced Healthcare Fraud Investigator to provide investigative support for civil healthcare fraud prosecutions on behalf of the U.S. Department of Justice. The investigator will work closely with Assistant U.S. Attorneys (AUSAs) to review, analyze, and develop healthcare fraud cases in compliance with federal Medicare and Medicaid regulations. Key Responsibilities Review, sort, and analyze complex data using Microsoft Excel and other software tools. Examine financial records, legal documents, and regulatory filings to identify evidence of fraud, waste, and abuse. Prepare detailed spreadsheets of financial transactions (e.g., check spreads). Develop healthcare fraud case referrals that meet USAO litigation standards. Evaluate referrals to determine need for additional evidence and plan investigative approaches. Advise attorneys on case merits, liability, damages, and potential defenses. Assist in witness interviews and prepare written summaries. Support development of new referrals through collaboration with federal, state, and local agencies. Assist in training and preparation of informational materials related to healthcare fraud. Perform other related duties as assigned within scope. Qualifications Education: Bachelor's degree or higher in Criminal Justice, Finance, Project Management, or a related field. Experience: Minimum of 3 years of professional experience in healthcare fraud investigation, healthcare compliance, or a related investigative field. Experience with federal healthcare programs (Medicare/Medicaid) strongly preferred. Proficiency in Microsoft Excel and data analysis tools required. Skills & Abilities: Strong analytical, research, and report-writing skills. Ability to interpret complex legal and regulatory documents. Excellent communication and collaboration skills. High ethical standards and ability to handle confidential information. Ability to work independently and under the direction of AUSAs. Contract Requirements & Conditions Must complete DOJ ethics training and Cybersecurity Awareness Training (CSAT) upon hire. Must adhere to all DOJ security, confidentiality, and conduct standards. Work schedule follows federal holidays and government office closures. Travel reimbursements in accordance with Federal Travel Regulations (FTR). Replacement of key personnel requires prior government approval. How to Apply Interested candidates should submit a resume and cover letter detailing relevant experience and qualifications. Resumes should clearly demonstrate education, experience, security clearance status (if applicable), and training relevant to healthcare fraud investigation. About Cameo Consulting Group, LLC Cameo Consulting Group, LLC is a small business providing specialized investigative and legal support services to federal agencies. This position is part of a awarded contract supporting the U.S. Attorney's Office in combating healthcare fraud. Cameo Consulting Group, LLC is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Health, Insurance & Financial Security Medical Insurance: Premium options with cost-sharing between the company and employee. 100% Employer-Paid Insurance: Cameo fully covers premiums for Dental, Vision, Basic Life, and Accidental Death & Dismemberment (AD&D) insurance. Disability Insurance: Options for both short-term and long-term disability coverage. 401(k) Retirement Plan: A plan to help employees save for the future. Flexible Spending Accounts (FSA): Pre-tax accounts for eligible healthcare and dependent care expenses. Paid Time Off & Work-Life Balance Federal Holidays: Paid time off for 11 federal holidays per year. Paid Time Off (PTO) / Sick Leave: A combined bank of paid leave for vacation, personal time, and illness. Other Leave: Paid time off for bereavement and jury duty. Employee Assistance Program (EAP): Confidential counseling and support services for personal or work-related challenges. Where We Work Program: A flexible work policy that may include a mix of hub office work, work-from-home, and fully remote roles, depending on the position. Professional Growth & Additional Perks Tuition Reimbursement: Financial support for continued education and degree programs. Continuous Training: Access to training programs for professional development. Employee Referral Bonus: A cash bonus for referring successful candidates. Shopping Discounts: Access to an employee discount program for various retailers and services. Cameo Consulting Group, LLC is an EEO Employer - M/F/Disability/Protected Veteran Status View all jobs at this company

SummaryJob Description Role Summary/Purpose The Investigator will be responsible for leading investigations relating to potential violations of law or other GE Vernova Policies. These investigations may be allegations of Conflict of Interest, Reporting and Recordkeeping violations, Respectful Workplace allegations (harassment/discrimination) or other Compliance areas. The Sr. Compliance Investigator will (1) lead investigations of policy concerns raised through the open reporting system; (2) provide regular updates on investigations to business stakeholders. (3) facilitate cross-training and report-outs with the broader compliance function at GE Vernova This role will report to the Sr. Compliance Investigations Manager - International. in the GE Vernova Compliance function. Essential Responsibilities Lead complex investigations of policy concerns raised through the open reporting system Provide regular updates on the status of cases to business stakeholders. Conduct prompt, thorough and complex investigations, including conducting interviews with concern raisers, witnesses and subjects, assessing risk, reviewing documentation, and making recommendations/corrective actions in the context of an investigation; in partnership with Compliance, L&E and the HR Manager, as appropriate. Prepare high quality written reports of the investigation which provide a clear and logical account of the allegations, investigative work performed, key findings and conclusions, ensuring that the conclusion is evidence based. Provide briefings to senior leaders on investigative matters as required. Maintain client relationships in the face of conflicting demands or directions. Monitor open cases assigned to you to ensure timeline and compliant closure, using established guidelines Conduct investigations outside your immediate region as required Partner with Compliance, Ombuds and other functions to identify and understand investigations trends and corrective actions In partnership with Labor & Employment, understand and apply applicable legal and policy requirements pertaining to the conduct of investigations including in areas involving employee interviews and relevant labor and employment requirements. Qualifications/Requirements Minimum of 7 years' experience in compliance, legal, investigations, audit or Human Resources Language proficiency within region required, and MUST be fluent in English. Highest personal integrity with demonstrated ability to handle confidential matters in a discreet and respectful manner Desired Characteristics Strong preference for candidate with experience in HR related investigations as well as Finance, legal or other regulatory related investigations. Demonstrated ability to make independent decisions, manage conflicting priorities in a fast-paced environment and effectively interface with high-level business and operations leaders. Proven communication, coaching and interpersonal skills with the ability to work effectively with people at all levels of the organization. Ability to support clients in multiple locations Strong analytical and problem-solving skills Process and detail oriented, including strong organization skills Experience driving business solutions through influence and collaboration in a global, matrixed organization Strong written and presentation skills Additional Information GE Vernova offers a great work environment, professional development, challenging careers, and competitive compensation. GE Vernova is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law. GE Vernova will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable). Relocation Assistance Provided: No #LI-Remote - This is a remote position For candidates applying to a U.S. based position, the pay range for this position is between $150,100.00 and $250,000.00. The Company pays a geographic differential of 110%, 120% or 130% of salary in certain areas. The specific pay offered may be influenced by a variety of factors, including the candidate's experience, education, and skill set.Bonus eligibility: ineligible.This posting is expected to remain open for at least seven days after it was posted on January 26, 2026.Available benefits include medical, dental, vision, and prescription drug coverage; access to Health Coach from GE Vernova, a 24/7 nurse-based resource; and access to the Employee Assistance Program, providing 24/7 confidential assessment, counseling and referral services. Retirement benefits include the GE Vernova Retirement Savings Plan, a tax-advantaged 401(k) savings opportunity with company matching contributions and company retirement contributions, as well as access to Fidelity resources and financial planning consultants. Other benefits include tuition assistance, adoption assistance, paid parental leave, disability benefits, life insurance, 12 paid holidays, and permissive time off.GE Vernova Inc. or its affiliates (collectively or individually, “GE Vernova”) sponsor certain employee benefit plans or programs GE Vernova reserves the right to terminate, amend, suspend, replace, or modify its benefit plans and programs at any time and for any reason, in its sole discretion. No individual has a vested right to any benefit under a GE Vernova welfare benefit plan or program. This document does not create a contract of employment with any individual.