Top 275 Fraud prevention Jobs in Belleville Nj

Senior Fraud Investigator-NYC (Hybrid)
1199SEIU Family of Funds —New York, NY
- $89,200 - $111,500 a year
- Full-time
- Microsoft Outlook
- HIPAA
- Office
Fraud Manager
BCB COMMUNITY BANK —Edison, NJ
- $90,000 - $110,000 a year
- Full-time
- Writing skills
- Office
- Bachelor's degree
Quick Apply
4d
Fraud Investigation and Operations Lead, Audible Fraud Defense, Business Risk Content
Amazon.com —Newark, NJ
- $133,300 - $185,000 a year
- Full-time
- Writing skills
- SQL
- Analysis skills
- AD&D insurance
- Health insurance
Security Guard
SALSON LOGISTICS INC —Newark, NJ
- $17 - $18 an hour
- Full-time
- Data entry
- Warehouse
- Warehouse experience
- Health insurance
- Dental insurance
8d
Asset Protection Supervisor, NY/NJ Office Security
Ralph Lauren —Nutley, NJ
- $18.55 - $38.60 an hour
- Weekends as needed
- Bilingual
- Microsoft Excel
- Microsoft Outlook
Teller Part Time
PNC Financial Services Group —Glen Ridge, NJ
- $17.31 - $28.85 an hour
- Part-time
- No experience needed
- No degree
- In-person
- Wellness program
- Health savings account
Surveillance Investigator
VRC Investigations —Newark, NJ
- Clean driving record
- Military
- Computer literacy
- Profit sharing
- Paid training
Quick Apply
Teller
PNC Financial Services Group —Jersey City, NJ
- $36,000 - $60,000 a year
- Full-time
- No experience needed
- No degree
- In-person
- Wellness program
- Health savings account
12d
Fraud Prevention Officer
Carver Federal Savings Bank —New York, NY
- $100,000 - $140,000 a year
- Word processing
- Research
- Mid-level
Quick Apply
6h
Relationship Banker
M&T Bank —Orange, NJ
- $25.07 - $41.79 an hour
- Full-time
- Bilingual
- Computer literacy
- Research
13d
Manager, Payment & Fraud
Caesars Entertainment —Jersey City, NJ
- $95,000 - $125,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- SQL
- Paid holidays
- Disability insurance
5d
Temporary Investigator - Czech Republic Assignment (30-60 Days)
Flanagan Security & Investigations Group —Glendale, NY
- $800 a day
- Temporary
- Mid-level
- Analysis skills
- In-person
Quick Apply
7d
Temporary Investigator - Germany Assignment (30-60 Days)
Flanagan Security & Investigations Group —Glendale, NY
- $800 a day
- Temporary
- Mid-level
- Analysis skills
- In-person
Quick Apply
7d
Safety - Training Mgr Exp
WFS Express, Inc. —Queens, NY
- $85,000 - $95,000 a year
- Management
- Mid-level
- 3 years
- 401(k)
- Employee discount
Quick Apply
Internal Auditor
Accelerated Global Solutions Inc —North New Hyde Park, NY
- $75,000 - $80,000 a year
- Full-time
- CPA
- ERP systems
- English
Quick Apply
22h
Interim Product Counsel (NYC Hybrid)
Major Lindsey Africa —New York, NY
- Urgently hiring
- Hybrid work
- 5 years
- English
- Senior level
- Parental leave
Senior Manager, Internal Audit
Barnes & Noble, Inc. —New York, NY
- $145,000 - $165,000 a year
- Full-time
- CPA
- Office
- Finance
- Paid parental leave
- Paid holidays
8d
Audit Manager I (US) - Issue Validation - Insider Risk / Internal Fraud
TD Bank —New York, NY
- $75,020 - $125,180 a year
- Full-time
- Microsoft Excel
- 5 years
- Writing skills
- Health insurance
- Paid time off
Senior E-commerce MOR/SOR Operations Manager
LG Electronics —Englewood Cliffs, NJ
- $140,000 - $175,000 a year
- Full-time
- English
- Bachelor's degree
- Children
- Paid parental leave
- Paid holidays
Quick Apply
Special Agent: Military/Law Enforcement Expertise
Federal Bureau of Investigation —New York, NY
- $103,326 - $133,200 a year
- Full-time
- Military
- Mid-level
- Bachelor's degree
7d

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fraud prevention jobs near belleville nj

Senior Fraud Investigator-NYC (Hybrid)

1199SEIU Family of Funds -
New York, NY

Apply Now

Job Details

Full-time
$89,200 - $111,500 a year

Qualifications

Healthcare financial misconduct investigations
Customer communication
Documentation review
Medical record review for billing accuracy
Documentation reviews

Full Job Description

Requisition #:

7462

# of openings:

Employment Type:

Full time

Position Status:

Agency Temp

Category:

Non-Bargaining

Workplace Arrangement:

Hybrid

Fund:

1199SEIU National Benefit Fund

Job Classification:

Exempt

Responsibilities

Conducts investigations into allegations of fraud, waste, or abuse, including preliminary assessments and full end-to-end case work.
Reviews and analyzes medical records, claims data, enrollment data, and other documentation to evaluate potential FWA.
Performs coding, billing, reimbursement, and medical necessity assessments based on CPT, HCPCS, ICD-9/10, DRG, and related coding guidelines.
Uses advanced data mining techniques to identify aberrant billing patterns, outliers, and other indicators of fraudulent activity.
Produces reliable, accurate and timely written investigative reports for internal and/external review detailing investigation findings, based on industry standard(s) and/or internal policy and procedure.
Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
Coordinates with various internal customers to gather documentation pertinent to investigations.
Incorporates communication skills to work with physicians, other health professionals, attorneys as well as external regulatory agencies and law enforcement personnel.
Communicate effectively and collaboratively with internal staff, leadership and external customers in a professional manner.
Conducts settlement negotiations with providers and/or attorneys.
Maintain the confidentiality required of the organization and the department.
Follow all Health Insurance Portability and Accountability Act (HIPAA) and Personal Health Information (PHI) requirements and regulations

Qualifications

Bachelor’s degree in business, criminal justice or related field.
Certified Professional Coder (CPC), Accredited Healthcare Fraud Investigator (AFHI), Certified Insurance Fraud Investigator (CIFI), and/or Certified Economic Crime Forensic Examiner (CECFE) preferred (but not required).
Minimum three (3) years’ experience with medical coding and medical record review performed required.
Minimum three (3) years’ experience in healthcare industry within a Special Investigation Unit (SIU) or equivalent governmental agency responsible for investigating healthcare fraud required.
Knowledge of medical coding and medical terminology.
Experience using STARSSolutions or other healthcare FWA case management and detection software preferred (but not required).
Proven track record in conducting investigations and/or the identification and pursuit of the recovery of overpayments.
Excellent report writing skills.
Knowledge of claims processing, reimbursement procedures, and a solid understanding of fraud detection and prevention practices.
Knowledge of data analysis of claims and documenting findings on spreadsheets.
Proficiency in Microsoft Office/Suite applications (Excel, Word, PowerPoint, Outlook, etc.).
Excellent interpersonal and communication skills – oral, written and listening.

This is a hybrid posiiton that will require you to report to our offices in Midtown Manhattan.

Apply Now

Refine Your Search

fraud prevention jobs in belleville nj

Senior Fraud Investigator-NYC (Hybrid)

Fraud Manager

Fraud Investigation and Operations Lead, Audible Fraud Defense, Business Risk Content

Security Guard

Asset Protection Supervisor, NY/NJ Office Security

Teller Part Time

Surveillance Investigator

Teller

Fraud Prevention Officer

Relationship Banker

Manager, Payment & Fraud

Temporary Investigator - Czech Republic Assignment (30-60 Days)

Temporary Investigator - Germany Assignment (30-60 Days)

Safety - Training Mgr Exp

Internal Auditor

Interim Product Counsel (NYC Hybrid)

Senior Manager, Internal Audit

Audit Manager I (US) - Issue Validation - Insider Risk / Internal Fraud

Senior E-commerce MOR/SOR Operations Manager

Special Agent: Military/Law Enforcement Expertise

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