Senior investigator work from home jobs

. Job Posting Closes at 11:59PM on: 12/24/25 Division: District Attorney Division Management Level: Individual Contributor Scheduled Weekly Hours: 40 Benefit Eligibility: This position is eligible for Standard Benefits which includes dental, medical, and vision insurance, paid time off and holidays, retirement matching, wellness programs, and tuition reimbursement. Description: The First Judicial District Attorney's Office is hiring a new Criminal Investigator. The Criminal Investigator is responsible for comprehensive investigative work to support prosecution activities of the District Attorney's Office. Collaborates with victims, law enforcement agencies, District Attorneys, defense counsel and team to achieve just outcomes, further the goals of the District Attorney and fulfill all statutory, constitutional and ethical obligations of an investigator. Anticipated Hire Range: $40.87 - $57.69 USD Hourly Compensation will be determined based on education, experience, and skills. Benefits: Jefferson County offers a generous benefits package that supports your personal and professional life. Benefits include medical, dental and vision insurance, paid time off and holidays, retirement matching, wellness programs, tuition reiambursement, flexible schedules, remote work options and more. For more information, click here for our Total Rewards summary. A Criminal Investigator is responsible for performing comprehensive investigative work to support prosecution activities of the District Attorney's Office. The following are duties assigned to the Criminal Investigator: Working closely with prosecutors in preparing criminal cases for trials, related hearings and testifying in court. Investigating alleged or suspected criminal violations of State laws to determine if there is sufficient evidence to recommend prosecution. Responsible for locating, contacting, and preparing state witnesses for trials, assisting various law enforcement personnel by providing investigative assistance and technical investigative support, assisting with training new investigators, making arrests and filing criminal cases. Other duties and responsibilities as assigned. Qualifications: Minimum Qualifications: Colorado POST Certification 5 years' experience in law enforcement including 3 years as a detective or investigator Associate degree in any discipline (experience may be substituted for education) Valid Colorado Driver's License within 30 days of hire Additional Job Information: Each applicant must be willing to submit to: Written testing Oral interviews Polygraph examination Background investigation to include a criminal, driving, reference, work, and credit history checks Psychological exam Applicants must be able to lawfully purchase and carry a firearm under Federal and State laws. Offer of employment contingent upon successful completion of criminal history, motor vehicle report, education verification, and/or references. Please note that supplemental questions requiring a written response will serve as a writing sample. Current Jefferson County employees must apply through their employee profile in Workday. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. About Us: At the First Judicial District Attorney's Office, we are committed to seeking fair and just outcomes for all members of our community through ethical prosecution and alternative resolutions. We work collaboratively with law enforcement to ensure those who victimize our most vulnerable members of society are held accountable. Our prosecution teams work collaboratively to support victims and ensure their voice is heard throughout the criminal legal system process. Our office is a nationally recognized leader in data transparency and data-driven practices in prosecution. We leverage technology, data analysis, innovative practices, and the use of alternative resolutions to ensure that justice is administered fairly and equitably. Our office culture is built around camaraderie and incorporating diverse perspectives in our day-to-day work. We are also committed to our team members' wellbeing outside of the workplace - we emphasize the importance of work-life balance, provide numerous resources to support health and personal development, and offer a comprehensive benefits package including substantial paid time off, generous holiday schedules, work from home flexibility, and a dog-friendly office. Education: Experience: Work Experience: Minimum five years Certifications: Languages: Category: District Attorney Post Certified

Airbnb was born in 2007 when two hosts welcomed three guests to their San Francisco home, and has since grown to over 5 million hosts who have welcomed over 2 billion guest arrivals in almost every country across the globe. Every day, hosts offer unique stays and experiences that make it possible for guests to connect with communities in a more authentic way. The Community You Will Join: Airbnb is a mission-driven company dedicated to helping create a world where anyone can belong anywhere. It takes a unified team committed to our core values to achieve this goal. Airbnb was born in 2007 when two hosts welcomed three guests to their San Francisco home, and has since grown to over 5 million hosts who have welcomed over 2 billion guest arrivals in almost every country across the globe. Every day, hosts offer unique stays and experiences that make it possible for guests to connect with communities in a more authentic way. The Difference You Will Make: The Insider Threat Investigations Manager oversees the rollout, operational quality, and ongoing effectiveness of BPO (Business Process Outsourcing) investigations into insider threats impacting Airbnb. This leader is responsible for building, scaling, and managing a global insider investigations program that empowers external (BPO) teams to deliver high-quality, compliant, and thorough investigations. As the program grows, the Manager will develop and oversee regional investigations leads, who will manage onboarding and ongoing support for BPO investigations teams in their geographic areas. For high-complexity and high-severity cases, the Manager acts as both lead and partner, driving joint investigations alongside BPO personnel to ensure delivery of best-in-class investigative outcomes. They will closely collaborate with their program counterpart within Security Engineering, collating security control vulnerabilities, building feedback channels, closing the loop of investigative findings, detection gaps, and emerging threats, to inform ongoing improvements in detection rules and workflows. They will collaborate extensively with Information Security, Legal, HR, and Risk & Compliance to safeguard Airbnb's assets and reputation. A Typical Day: Program Leadership, Scalability & Operational Oversight Deploy, and evolve the BPO Insider Threat Investigations program to support global operations and future growth. Develop the framework to scale the program regionally by recruiting, onboarding, and managing regional investigations leads. Oversee directly, then delegate operational oversight to regional leads in the delivery of standardized BPO onboarding, ongoing training, operational review and maintenance for both new and existing BPO investigation teams. Conduct continuous assessments of BPO investigations and regional teams to ensure thoroughness, technical accuracy, compliance, and alignment with Airbnb standards. Lead global feedback cycles, and knowledge-sharing sessions across internal teams, regional leads, and all BPO investigators. Serve as an escalation point for high-impact cases, ensuring prompt response and resolution in collaboration with regional leads and BPO teams. Coordinate with Security Engineering on the rollout, scaling and performance review of detection models, ticketing systems, and remediation action specifically designed for the BPO use case. Investigation Management & Joint Case Leadership Oversee BPO and regional investigation workflows for diverse insider threat risks (financial misconduct, IP theft, production abuse, unauthorized access, etc.). Prioritize and define key performance indicators (KPIs) for BPO investigation teams to ensure investigations are thorough, compliant, and aligned with Airbnb standards. Oversee and enforce SLAs for investigations, ensuring investigations begin promptly and final reports are delivered within defined timeframes. Personally lead and coordinate joint investigations and subject interviews in partnership with BPO teams and regional leads on complex, high-severity matters. Assure all investigations reflect proper evidence handling, digital forensics, interview practices, and documentation in line with legal, regulatory, and corporate requirements. Guidance for Investigations Set investigation and response standards and provide log analysis guidance to BPO teams, then to internal regional leads. Align regional leads and BPO investigators with internal resources, tools, and subject matter expertise as needed. Legal Acumen, Compliance, and Reporting Ensure global investigations comply with employment law, data privacy regulations, company policies, and relevant commercial frameworks. Collaborate with Legal, Talent, Privacy, and Risk and Compliance both centrally and via regional leads to support effective risk management and remediation. Deliver structured, cross-functional and executive-level reports and briefings on regional and global threat, vulnerability, and BPO security health metrics and synthesize lessons learned for continuous improvement. Your Expertise: Experience & Expertise 10+ years of professional experience in insider threat investigations, enterprise security, investigations into applications, production environments, or equivalent. Demonstrated experience overseeing investigation teams and/or managing vendor/BPO programs at scale, preferably including global/regional operations. Experience establishing and managing regional leadership structures in investigations, with a track record of onboarding, training, and supporting geographically distributed teams. Strong background in technical investigation, digital forensics, and operational quality assurance. Managerial & Program Skills Proven ability to build and scale enterprise investigation programs, including development of regional leadership/oversight capabilities. Skilled in mentoring, enabling, and coaching both direct and indirect (e.g., BPO/regional) investigation teams. Capable of designing and implementing regional onboarding programs and maintaining operational standards worldwide. Legal Acumen Deep understanding of employment law, data privacy, and regulatory compliance relevant to large-scale, cross-border investigations. Preferred Certifications General/Corporate/Workplace Investigations CFE, PCI, CPP, CFI, SHRM-Internal Investigations Cyber Security Awareness Courses(e.g. Google Cybersecurity Certificate) Insider Threat & Threat Assessment CERT ITPM, NaBITA, Behavioral Science. Project Management Professional (PMP); Agile Certified Practitioner (PMI-ACP) Additional Attributes Demonstrated ability to communicate program strategy, status, and risk effectively to senior leaders and cross-functional teams globally. Analytical thinker with a commitment to operational excellence, scalability, and continuous program improvement. Your Location: This position is US - Remote Eligible. The role may include occasional work at an Airbnb office or attendance at offsites, as agreed to with your manager. While the position is Remote Eligible, you must live in a state where Airbnb, Inc. has a registered entity. Click here for the up-to-date list of excluded states. This list is continuously evolving, so please check back with us if the state you live in is on the exclusion list If your position is employed by another Airbnb entity, your recruiter will inform you what states you are eligible to work from. How We'll Take Care of You: Our job titles may span more than one career level. The actual base pay is dependent upon many factors, such as: training, transferable skills, work experience, business needs and market demands. The base pay range is subject to change and may be modified in the future. This role may also be eligible for bonus, equity, benefits, and Employee Travel Credits. Pay Range$154,000-$192,000 USD

Stripe is a financial infrastructure platform for businesses. Millions of companies-from the world's largest enterprises to the most ambitious startups-use Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our mission is to increase the GDP of the internet, and we have a staggering amount of work ahead. That means you have an unprecedented opportunity to put the global economy within everyone's reach while doing the most important work of your career. About the team Stripe is both a technology company and a financial services company, and you will need to be comfortable straddling both of those worlds every day. The right person for the role will enjoy dealing with that puzzle, seeking creative solutions and moving quickly, often in the face of ambiguity. The right person for the role will also be comfortable getting their hands dirty by directly working on critical parts of the Americas financial crimes program, as well as being an effective people manager. The Financial Crimes, Compliance, and Risk Oversight (FinCRO) Investigations Management team is responsible for providing second line of defense (2LoD) financial crime risk oversight and coordination over casework, the management of user risk and other investigative oversight responsibilities for Stripe's global operations. The Investigations Management function will take part in local exams, field financial partner inquiries, and respond to law enforcement or other external inquiries. What you'll do We are looking for an Americas Financial Crimes Investigations Lead based in the US. This role focuses on leading a team of investigators and analysts conducting anti-money laundering (AML), counter-terrorist financing (CTF), sanctions, and other financial crimes and regulatory compliance investigations in support of Stripe's growing business. Responsibilities Lead a team of Financial Crime Analysts located across the Americas region (US, Canada, and Latin America) Provide guidance and support to the Americas team, in order to conduct a wide variety of analyses, potentially including: Investigations into money laundering, terrorist financing and other financial crimes and reporting of this activity through Suspicious Activity Reports (SARs) or Suspicious Transaction Reports (STRs) Conduct OFAC and BIS screening ("watchlist") and sanctioned jurisdictions screening (“keyword”) reviews, manually reviewing Stripe merchant accounts, and reviewing investigations work products, as part of Stripe's sanctions program Assessments of customer risks, including KYC and Due Diligence investigations for high risk customers, inclusive of Politically Exposed Persons (PEPs) Management of customer risk to Stripe, including the assessment of user retention and offboarding of users Assist the team in the investigation and response to requests for information from banking and financial partners, including the direct management of financial partner relationships Drive complex intelligence investigations and analytical workstreams, coordinating with Stripe's Complex and Major investigations teams Demonstrate sound judgment and an ability to navigate non-binary, high-risk decisions, and effectively communicate these decisions to the wider team Adhere closely to process while still constantly questioning assumptions, suggesting improvements, and following up implementation of those improvements Effectively and clearly communicate, including with other Stripes, Stripe's users, and Stripe's financial partners Demonstrate ownership of the Americas Financial Crimes program, and constantly seek improvements and accountability both within the team, as well as with our Financial Crimes Operations teams Who you are We're looking for someone who meets the minimum requirements to be considered for the role. If you meet these requirements, you are encouraged to apply. The preferred qualifications are a bonus, not a requirement. Minimum requirements 5+ years experience in investigations, operations, or advisory roles within financial crimes, AML, sanctions, risk, fraud, research, or a related field 2+ years experience leading financial crimes investigation teams of varying size and complexity Investigative expertise and strong knowledge of BSA, AML, US Patriot Act, and OFAC regulations Excellent research and writing skills Ability to synthesize large amounts of information, including transaction data Ability to work efficiently and independently in a fast-paced environment Ability to work cross-functionally with internal stakeholders Preferred qualifications ACAMS, ACAMS CGSS or ACSS Certification Familiarity with evaluating STRs and other regulatory reports to FINTRAC and Canadian Law Enforcement, as well as SAR reporting and regulatory requirements in Brazil. MS Excel experience SQL abilities Familiarity with MacOS and Google products Technical curiosity and an interest in evolving sanctions, AML, or regulatory compliance trends Foreign language fluency, including Spanish or Portuguese

Looking for a company that treats associates with respect, understanding, and appreciation? Looking for a company that is passionate about teamwork and the growth of it's associates and communities? That's WEIS! 1000 Weis Remote Road Job Description: ESSENTIAL DUTIES AND RESPONSIBILITIES The associate is responsible for the functions below, in addition to other duties as assigned: Investigate and resolve external theft (Shoplifting, Organized Retail Crime, etc.). Gathers, analyzes, and evaluates intelligence on individuals and groups involved in organizational retail crime. Thoroughly documents information gathered to aid in successful prosecution. Provides guidance to store Asset Protection teams on investigative plans. Operate the store CCTV system. Conduct undercover surveillances. Act as a liaison between Weis Markets and local, state, and federal law enforcement agencies. Refers cases to law enforcement for prosecution. Professionally represent Weis Markets in court hearings and mediations. Effectively manage time and scheduling to best suit the company's needs including evenings, weekends, and occasional overnights. Travel to multiple locations within an assigned area and provide investigative support. Partners with Store Management and associates to best protect the company assets. Supports stores in cases of significant business disruptions (robbery, protests, natural disasters, etc.). SUPERVISORY RESPONSIBILITIES This position does not directly supervise associates. QUALIFICATION REQUIREMENTS To perform this job successfully, the associate must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required: Bachelor's degree (BA/BS) Criminal Justice, Criminology, Business, or related field preferred, plus one (1) year retail loss prevention experience in a retail store environment. Weis Markets is an Equal Opportunity Employer: Weis Markets is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of actual or perceived age, sex, sexual orientation, race, color, creed, religion, familial status, ethnicity, national origin, citizenship, disability, marital status, military or veteran status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. Applicants with a disability may be entitled to a reasonable accommodation under terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the ways things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Weis Markets.

Mfinite Consulting, LLC Mfinite Consulting is seeking an experienced Special Education Complaint Investigator to support on an as-needed, contract basis. This role is ideal for professionals with strong knowledge of special education regulations, exceptional writing skills, and prior investigative experience. This is a part-time, case-by-case assignment offering flexible scheduling. Each investigation is expected to take approximately 20 hours to complete. Key Responsibilities Identify Legal Questions: Review complaints and determine the applicable legal and regulatory issues. Conduct Investigations: Review relevant documents and evidence Perform legal and regulatory research Interview involved parties and stakeholders Draft Findings: Prepare a formal determination letter summarizing findings and conclusions in accordance with required standards. Collaborate Professionally: Maintain communication, timelines, and documentation throughout each assigned investigation. Required Qualifications Work Experience Experience with federal and state special education laws, regulations, and guidance Demonstrated experience conducting investigations Strong technical writing and analytical skills Ability to work independently and conduct legal research Education Bachelor's degree in Special Education required Juris Doctor (JD) strongly preferred Work Environment Work is performed remotely, with occasional on-site requirements as needed. Contractors will complete investigations individually and must be able to manage workload efficiently. Contract Details This is a 1099 independent contractor role. Contractors will be compensated on an hourly basis, ranging from $60 to $75 per hour, depending on their experience and qualifications. Monthly invoices are required for work performed. How to Apply Submit the following: Updated resume demonstrating required qualifications Brief statement of interest Hourly rate expectation

Treliant is a global consulting firm serving banks, mortgage originators and servicers, FinTechs, and other companies providing financial services. We are led by practitioners from the industry and the regulatory community who bring deep domain knowledge to help our clients drive business change and address the most pressing compliance, regulatory, and operational challenges. We provide data-driven, technology-enabled advisory and consulting, implementation, staffing and managed services solutions to the regulatory compliance, risk, financial crimes, and capital markets functions of our clients. Founded in 2005, Treliant is headquartered in Washington, DC, with offices across the United States, London, Belfast, and Łódź, Poland. For more information visit ***************** Treliant is committed to fostering a diverse, equitable and inclusive environment that values and embraces all races, religions, ages, abilities, gender, sexual orientations, ethnicities, languages, nationalities, political parties, socioeconomic groups and other characteristics that inform an individual worldwide view and experiences and systems of beliefs (“the principles”). We believe in championing every voice and ensuring everyone's full potential. We are looking for Financial Crimes Investigators with an expertise in blockchain and cryptocurrencies to join our team for remote, project-based opportunities. Responsibilities While the scope of each project may be different, your duties & responsibilities may include: Conduct thorough Blockchain Tracing investigations into potential financial crimes, including AML, fraud, and sanctions violations. Ensure clients meet regulatory and compliance standards by performing EDD/ CDD checks, KYC assessments and analyzing source of funds. Analyze cryptocurrency transactions and wallet addresses, leveraging blockchain explorers and analytics tools to track illicit activity or suspicious behavior. Draft and submit SARs to relevant authorities Identify and assess potential financial crime risks across all client portfolios, leveraging both traditional and crypto-related financial systems. Work closely with regulatory agencies, and financial institutions to ensure compliance with global anti-money laundering (AML) and counter-financing of terrorism (CFT) regulations. Investigate high-volume or high-value transactions, including cross-border transfers, to identify red flags or signs of illegal activities. Qualifications Strong education background; Bachelor's Degree preferred. 3+ years of experience in Financial Crime; either directly with a bank/financial institution or via a third party providing consulting services. Strong background in AML, CTF or Sanctions, with an understanding of the compliance and regulatory frameworks that apply. Familiarity with cryptocurrency blockchain tracing and blockchian technologies including investigating transactions on blockchain platforms and identifying risks associated with digital assets. Familiarity with blockchain forensics tools such as Chainalysis, Elliptic, or CipherTrace to trace and analyze crypto transactions. Knowledge of global regulatory frameworks for crypto - understanding of evolving cryptocurrency regulations, including FATF's Travel Rule, KYC/AML compliance for digital assets, and the legal landscape around crypto in different regions. Experience in developing risk mitigation strategies for crypto-based financial crimes, including fraud prevention and transaction monitoring in the crypto space. We are committed to being an Equal Opportunity Employer and want to build a diverse, inclusive and authentic workplace. If you are interested in working for Treliant but don't tick all the boxes, we encourage you to apply as you may be the perfect candidate for this or other roles. Benefits Primary Location: Remote Primary Location Salary Range: $50/hr - $60/hr Treliant offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefit package that reflects our commitment to creating a diverse and supportive workplace. In addition to a competitive base salary, candidate is eligible for incentive pay as well as a full range of health benefits, vacation plan, and 401k plan. If you want to be part of a dynamic team of professionals, we invite you to join the team at Treliant. We invest in people, and challenge you to advance your career while achieving your aspirations and goals. Here at Treliant, we pride ourselves on our collaborative team culture, where we embrace diversity of thought and innovation. If you strive for excellence and seek an inclusive environment apply on line treliant.com and follow us on LinkedIn. Right to Work Treliant is not in the position to provide sponsorship for this current position and so applicants must be able to work in the United States without requiring sponsorship. Please note, Treliant receives a high volume of applications for all roles. While we will endeavor to respond to all applicants, this is not always possible. Should you not receive a response to your application within 2 weeks, it is likely that you will have been unsuccessful on this occasion. However, we would like to retain your details on our systems and may contact you should another potentially suitable vacancy arise. Treliant LLC is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, sexual orientation, genetic information, religion, age, disability, or military status in employment or provision of services. When contacted for an interview, an applicant who requires special accommodations due to a disability should notify the office so that proper arrangements can be made.

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! Modivcare is looking for an experienced Special Investigator III to join our team. As the senior member of our Special Investigations Unit (SIU), this role leads complex investigations into allegations of fraud, waste, and abuse (FWA) and internal compliance violations. The position provides mentorship and oversight to other investigators while collaborating with Legal, People & Culture, Compliance, and external stakeholders, including clients and law enforcement agencies. This role… Serves as lead investigator for complex or high-profile FWA and internal compliance cases. Conducts and manages internal investigations involving policy violations, ethics concerns, and operational noncompliance. Provides case oversight and mentorship to Special Investigator I and II team members, including reviewing documentation for quality and accuracy. Coordinates multi-regional investigative strategies and ensures compliance with federal, state, and contractual requirements. Analyzes data trends and case metrics to identify systemic risks and recommends corrective actions. Develops and refines investigative protocols, templates, and best practices in partnership with leadership. Prepares and delivers high-quality reports, executive summaries, and referral packets for clients, agencies, or internal stakeholders. Collaborates with legal, compliance, and operational teams on investigations and remediation. Leads regular and ad hoc status calls with clients, brokers, or law enforcement on open cases. Acts as a subject matter expert for investigative practices, both external and internal. Provides training to SIU staff, Compliance, and cross-functional teams on investigations and prevention. Supports data analytics initiatives through trend identification and algorithm validation. Represents the SIU and Compliance teams during audits and compliance reviews. May lead cross-functional projects or serve as acting SIU Supervisor in the absence of leadership. Provides functional direction, mentoring, and peer review for Special Investigator I and II roles. May lead cross-functional teams on complex or high-visibility investigations. Performs other duties as assigned. We are interested in speaking with individuals with the following… Bachelor's degree in Criminal Justice, Healthcare Administration, or a related field required. Five (5) plus years of progressive experience in fraud investigations, compliance, or law enforcement. Demonstrated experience leading or supervising investigations or project teams. Equivalent combination of education and experience may be considered. Expert knowledge of investigative methodologies for both external FWA and internal compliance cases. Strong analytical and data interpretation skills. Excellent written and verbal communication skills, with the ability to present findings to executives or regulators. Demonstrated leadership, mentoring, and case management abilities. Proficiency with case management systems and data visualization tools (e.g., Power BI, Excel). High level of integrity, discretion, and sound judgment when handling sensitive or confidential information. Ability to manage multiple investigations concurrently and deliver timely, high-quality outcomes. Salary: $52,900 - $71,400 Modivcare's positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings. We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package to include the following: Medical, Dental, and Vision insurance Employer Paid Basic Life Insurance and AD&D Voluntary Life Insurance (Employee/Spouse/Child) Health Care and Dependent Care Flexible Spending Accounts Pre-Tax and Post --Tax Commuter and Parking Benefits 401(k) Retirement Savings Plan with Company Match Paid Time Off Paid Parental Leave Short-Term and Long-Term Disability Tuition Reimbursement Employee Discounts (retail, hotel, food, restaurants, car rental and much more!) Modivcare is an Equal Opportunity Employer. EEO is The Law - click here for more information Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at ***************************

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. We are currently hiring for multiple positions. Candidates for these role must reside in one of the following states: CA, HI, IL, NE, and OH. Position Purpose: Investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse. Conduct investigations of potential waste, abuse, and fraud Document activity on each case and refer issues to the appropriate party Perform data mining and analysis to detect aberrancies and outliers in claims Develop new queries and reports to detect potential waste, abuse, and fraud Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions Assist with complex allegations of healthcare fraud Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies Complete various special projects and audits Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's Degree in Business, Criminal Justice, Healthcare, related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation experience. Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

The SIU Audit Investigator supports the compliance related activities of the Special Investigations Unit (SIU) at the Health Plan. This role assists the External Audit Senior Manager with developing, implementing and performing compliance related auditing and monitoring activities at the Health Plan. This includes the identification, investigation and correction of fraudulent and/or abusive billing and coding practices; coordination of recovery of overpayments related to fraudulent and/or abusive billing and coding practices; and providing education related to coding, medical record documentation requirements, healthcare compliance and fraud, waste and abuse to Health Plan staff, vendors and contracted providers/facilities. Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan welcomes 100% remote work for applicants who reside in the following states: Washington Oregon California Required Qualifications: Bachelor's Degree Or equivalent combination of education and experience. 5 years Coding experience with a healthcare provider, facility or health insurance company. 2 years Fraud and Abuse audit experience in a health insurance company, healthcare provider, facility or other relevant healthcare environment. Project management experience, education program development experience and group presentation experience. Experience in use of data mining software/tools. Preferred Qualifications: Current certification as an Accredited Healthcare Fraud Investigator (AHFI) upon hire. Certification as an Internal Auditor or Healthcare Compliance certification upon hire. Clinical background. Salary Range by Location: California: Humboldt: Min: $29.62, Max: $45.31 California: All Northern California - Except Humboldt: Min: $33.23, Max: $50.84 California: All Southern California - Except Bakersfield: Min: $29.62, Max: $45.31 California: Bakersfield: Min: $28.41 Max: $43.47 Oregon: Non-Portland Service Area: Min: $26.49, Max: $40.52 Oregon: Portland Service Area: Min: $28.41 Max: $43.47 Washington: Western - Except Tukwila: Min: $29.62, Max: $45.31 Washington: Southwest - Olympia, Centralia & Below: Min: $28.41 Max: $43.47 Washington: Tukwila: Min: $29.62, Max: $45.31 Washington: Eastern: Min: $25.28, Max: $38.68 Washington: South Eastern: Min: $26.49, Max: $40.52 Why Join Providence Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

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

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

WHAT IS THE OPPORTUNITY? Responsible for performing and documenting through root cause analysis on clients' transactions identified through fraud operations and strategy to identify rings, scams, fraudulent activities that impact CNB's clients, and corporate losses. Additionally, the Fraud Investigator will quarterback internal events and investigation activities to strengthen operational processes to reduce fraud risk. WHAT WILL YOU DO? * Perform analysis on clients' transactions identified through the monitoring system that involves various transaction types including but not limited to credit, cash, wire transfers, remote deposit capture and loans. * Conduct and document, timely investigations with well-reasoned and supported decision-making. * Utilize a variety of internal bank systems and external research tools to investigate, research, and prepare documentation related to fraud investigations consistent with the resolution of the investigation and perform root cause analysis to identify solutions to reduce future fraud risk. * Conducts follow-up with line colleagues and clients for any missing or necessary information. * Demonstrate personal excellence including punctuality, integrity, and accountability. * Think critically and exercise independent judgement. * Apply subject matter expertise in the financial services industry to drive improved fraud detection and prevention. * Champion activities across the fraud organization for identified risk events. * Provide escalation support for fraud operations. * Communicate emerging fraud trends across client operations. WHAT DO YOU NEED TO SUCCEED? *Required Qualifications** * Bachelor's Degree or equivalent * Minimum 5 years experience in risk management or fraud related functions * Minimum 5 years experience in fraud investigations *Additional Qualifications* * Must work well in a team environment, as well as independently. * Advanced computer experience required (e.g., MS Word, Outlook and Excel) * Analytical skills, use of good judgment, attention to detail, internet savvy. * Solid understanding of deposit, credit, and money movement transactions and potential fraud attack vectors. * Must have a strong and positive work ethic and follow CNB core values. * Must be flexible and adapt quickly to change. * Must be able to multi-task, adapt well to changing priorities, and meet specific performance goals. * Advanced Knowledge of PC functions in a Windows based environment. * Proficient in Excel and Word. * Effective written and oral communication skills to interact effectively with all levels of bank personnel and clients. * Demonstrated experience in root cause analysis and event management coordination. * CFE and/or CFCI certification desired * Familiarity/proficiency in programming tools such as Snowflake, Python, SAS for data queries desired *WHAT'S IN IT FOR YOU?* *Compensation*Starting base salary: $65,296 - $104,304 per year. Exact compensation may vary based on skills, experience, and location. This job is eligible for bonus and/or commissions. *Benefits and Perks* At City National, we strive to be the best at whatever we do, including the benefits and perks we offer our colleagues including: * Comprehensive healthcare coverage, including Medical, Dental and Vision plans, available the first of the month following start date * Generous 401(k) company matching contribution * Career Development through Tuition Reimbursement and other internal upskilling and training resources * Valued Time Away benefits including vacation, sick and volunteer time * Specialized health and family planning benefits including fertility benefits, and cancer, diabetes and musculoskeletal support programs * Career Mobility support from a dedicated recruitment team * Colleague Resource Groups to support networking and community engagement Get a more detailed look at our ********************************* ABOUT US Since day one we've always gone further than the competition to help our clients, colleagues and communities flourish. City National Bank was founded in 1954 by entrepreneurs for entrepreneurs and that legacy of integrity, community and unparalleled client relationships continues today. City National is a subsidiary of Royal Bank of Canada, one of North America's leading diversified financial services companies. To learn more about City National and our dynamic company culture, visit us at ********************************** *INCLUSION AND EQUAL OPPORTUNITY EMPLOYMENT* City National Bank fosters an inclusive environment where all forms of diversity are valued and leveraged to make us a better company and employer. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, national origin, disability, veteran status or other basis protected by law. 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. *Represents basic qualifications for the position. To be considered for this position, you must at least meet the required qualifications. careers.cnb.com accepts applications on an ongoing basis, until filled. Unless otherwise indicated as fully remote, reporting into a designated City National location is an essential function of the job.

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!

class:( $data.display Type === 'InputTextArea') ? 'block__field--full-width' : ($data.display Type === 'InputRichText' || $data.name === 'description Ext' || $data.name === 'qualification Ext' || $data.name === 'description Int' || $data.name === 'qualification Int') ? 'block__field--wide-rich-text' : 'block__field--edit'}" id="description Int-container" html: $component.get FieldValue($data)" id="description Int-value" formfieldid="description Int" UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday through Friday 8:00 a.m. to 4:30 p.m. This is a remote position. Under the direction of the manager, the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud, waste and abuse (FWA) cases, as well as researching and analyzing claims data in order to identify potential FWA. The SIU Investigator is also responsible for maintaining the FWA case system with accurate and detailed investigative activities related to assigned cases. This role includes supporting current SIU staff and manager with investigations and special projects. Responsibilities: + Maintain neat and organized files and electronic databases + Prepare letters, memos, and reports + Financial tracking + Understand and adhere to HIPAA privacy requirements + Proficiency with Microsoft Office products such as Word, Excel, Outlook and PowerPoint. + Perform other duties as assigned + Support all department personnel with duties including but not limited to investigations, audits, and regulatory referrals. + High School Diploma Strongly Preferred. + Post-secondary education is preferred. + One year of administrative support working experience is highly preferred. + Must have proficiency with Microsoft Office Suite: Excel, Word, Outlook and Powerpoint. + Must possess typing skills and working knowledge of word processing, electronic mail/calendar and spreadsheets. + Must possess the ability to learn and effectively use various software programs. + General knowledge and experience with office equipment such as copiers, multi-line phone systems, fax machines and paging systems Preferred Qualification: + Experience in investigations, claims, medical coding, auditing, compliance, risk management and/or data analysis required Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers' evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers. Job Description This job is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of complex attorney represented and unrepresented claims and moderate to complex losses, in which suspicious activity has been identified. The individual performs a thorough investigation including; (1) conducting background searches, scene investigations, and clinic inspections; (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills, and property damage; and (4) conducting witness interviews and social media searches. The individual conducts surveillance on property and/or creates scene reconstructions on some investigations and reviews whether fraud can be substantiated and supports a lawsuit. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team.**We're seeking an experienced SIU Field Investigator to join our Special Investigations Unit (SIU) in Florida! This is a field-based, location-specific position, and the ideal candidate will reside in or near Sarasota, Lee, Manatee, or the Port Charlotte area.**Key Responsibilities • Reviews investigations with fraud outcomes to validate whether denial is appropriate • Conducts complex site inspections, including body shops, medical clinics, loss locations etc. • Enters SIU claim data information into multiple SIU systems • Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement • Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed • Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages • Conducts complex online data application searches, research, and evaluation • Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads • Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process • Researches and responds to complex customer communications, concerns, conflicts or issues Supervisory Responsibilities • This job does not have supervisory duties. #LI-TR1 Compensation Base compensation offered for this role is $57,500 - $105,000 annually and is based on experience and qualifications. Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) as applicable for the role. Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger - a winning team making a meaningful impact. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company's policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment. National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A- (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products. Companies & Partners Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident. Benefits National General Holdings Corp. is an Equal Opportunity (EO) employer - Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at **************.

UPMC Health Plan has an exciting opportunity for a Special Investigations Unit Investigator position. This is a temporary position working Monday through Friday 8:00 a.m. to 4:30 p.m. This is a remote position. Under the direction of the manager, the Special Investigations Unit (SIU) Investigator is responsible for investigating assigned fraud, waste and abuse (FWA) cases, as well as researching and analyzing claims data in order to identify potential FWA. The SIU Investigator is also responsible for maintaining the FWA case system with accurate and detailed investigative activities related to assigned cases. This role includes supporting current SIU staff and manager with investigations and special projects. Responsibilities: * Maintain neat and organized files and electronic databases * Prepare letters, memos, and reports * Financial tracking * Understand and adhere to HIPAA privacy requirements * Proficiency with Microsoft Office products such as Word, Excel, Outlook and PowerPoint. * Perform other duties as assigned * Support all department personnel with duties including but not limited to investigations, audits, and regulatory referrals. * High School Diploma Strongly Preferred. * Post-secondary education is preferred. * One year of administrative support working experience is highly preferred. * Must have proficiency with Microsoft Office Suite: Excel, Word, Outlook and Powerpoint. * Must possess typing skills and working knowledge of word processing, electronic mail/calendar and spreadsheets. * Must possess the ability to learn and effectively use various software programs. * General knowledge and experience with office equipment such as copiers, multi-line phone systems, fax machines and paging systems Preferred Qualification: * Experience in investigations, claims, medical coding, auditing, compliance, risk management and/or data analysis required Licensure, Certifications, and Clearances: * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

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

No prior experience required! We provide comprehensive training to help you build a career in financial crime compliance. As an Entry-Level Anti-Money Laundering (AML) Investigator, you will review transactions, identify suspicious activity, and ensure Know Your Customer (KYC) compliance. Work Arrangement & Schedule This role may involve work from home, full-time in-office, or a hybrid arrangement. The specific work arrangement will be determined by the Company based on client engagement requirements and may change during employment. Candidates must live within 40 miles of either our Highland Hills (23000 Millcreek Blvd) or Cleveland (1300 E 9th Street, Suite 200) office, as there may be a requirement for a fully in-office schedule if requested by the client. Company-Provided Training (First Three Weeks): Virtual participation from home, Monday through Friday, 9:00 AM - 5:30 PM EST. Full attendance and active engagement are required throughout this period. Core Hours (After Training): Monday through Friday, 8:00 AM - 5:00 PM local time (subject to operational needs). Key Responsibilities Evaluate and monitor transactional activity to identify potential suspicious activity. Verify client identities and assess their relationships with financial institutions for Know your Customer (KYC) purposes. Interpret and implement client-operating policies related to financial data. Identify data anomalies and red flags for money laundering, terrorist financing, fraud, sanctions violations, and escalate for second level review. Write clear, concise reports summarizing findings and recommendations. Use basic Excel functions and technology applications (Microsoft, internet) for analysis. Adhere to designated timeframes and procedures to ensure timely and accurate completion of tasks. Submit written work product for review by internal quality control teams and make necessary adjustments based on feedback. Meet production and quality standards while working collaboratively in a team-oriented environment. Ensure compliance with federal and state laws, regulations and company policies, and client requirements related to Anti-Money Laundering. Qualifications Bachelor's Degree required. Must reside within 40 miles of either the Highland Hills (23000 Millcreek Blvd, Highland Hills, OH 44122) or Cleveland (1300 E 9th Street, Suite 200, Cleveland, OH 44114) offices. Strong written and verbal communication skills and ability to learn quickly. Analytical mindset with attention to detail and organizational skills. Proficiency in Microsoft Excel; familiarity with other Office tools. Ability to adapt to feedback, work independently, and identify process improvements. Advanced Excel skills (pivot tables, filtering, sorting) and strong research skills are a plus. Compensation & Benefits Starting at $40,000, with an increase to $42,000 after the initial 90-day probationary period, contingent upon meeting performance expectations. Comprehensive health, dental, and vision benefits Paid time off and holidays Professional development opportunities Collaborative work environment with global exposure About Us AML RightSource is the leading technology-enabled managed services firm focused on fighting financial crime. Headquartered in Cleveland, Ohio, we operate globally as a trusted partner to financial institutions, FinTechs, and corporations. Our team of 7,000+ compliance professionals combines expertise, technology, and consulting to help clients with AML/BSA, transaction monitoring, KYC, EDD, and risk management. Together, we are Reimagining Compliance. AML RightSource,LLC will not provide sponsorship for employment visas or participate in STEM OPT for this position. AML RightSource may use AI tools to support candidate screening; however, all hiring decisions are made through human review. We are committed to providing accommodations to individuals with disabilities throughout all aspects of the recruitment process. If you require accommodation to participate in the recruitment and selection process, please email ************************* or discuss your needs when contacted for an interview. AML RightSource is committed to fostering a diverse work environment and is proud to be an equal opportunity employer. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Recruitment Scam Alerts We're aware of an increase in recruitment scams where individuals falsely claim to represent AML RightSource. These scammers may ask for money or personal information by offering fake job opportunities through e-mail, text message or social media. Please verify the source of any job-related communications carefully. All official AML RightSource communications are conducted through "@amlrightsource.com" email addresses. If you encounter suspicious messages, do not respond.