Top 121 Fraud Jobs in Ohio

SIU Investigator
Centene —Ohio
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- Associate's degree
- Paid holidays
- Health insurance
Sr. Analyst, Fraud & Investigations
Nationwide —Grandview Heights, OH
- 8 hour shift
- Hybrid work
- Microsoft Excel
- Mid-level
- Office
- Paid holidays
- Disability insurance
9d
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Ohio
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Fraud Risk Analyst
U.S. Bank National Association —Cincinnati, OH
- $105,400 - $124,000 a year
- Full-time
- 6 years
- Mid-level
- Office
- Paid holidays
- Disability insurance
Operations Division Manager - Fraud Solutions-- Head of Fraud Products, Segments and Channels
KeyBank National Association —Brooklyn, OH
- $116,000 - $216,000 a year
- Full-time
- Remote
- Bachelor's degree
- Experience equivalent to degree accepted
- In-person
Toledo - BWC Fraud Analyst - PN: 20066657
State of Ohio - Workers' Compensation —Toledo, OH
- $34.53 - $50.66 an hour
- Full-time
- Background check
- Customer service
- Word processing
- Paid holidays
- Health insurance
7d
Senior Compliance Investigator
Centene —Ohio
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Compliance Manager
Mission Lane —Columbus, OH
- $129,000 - $140,000 a year
- Full-time
- Remote
- 6 years
- Travel
- Senior level
- Paid parental leave
- Disability insurance
Director Fraud Strategy
Bread Financial —Columbus, OH
- $134,400 - $319,900 a year
- Full-time
- 5 years
- Research
- Office
- Paid parental leave
- Paid holidays
Fraud Account Specialist I
JPMorganChase —Columbus, OH
- Weekends as needed
- Computer literacy
- High school diploma or GED
- 1 year
- Health insurance
- Tuition reimbursement
3h
Auditor/Investigator II
Qlarant —Ohio
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Surveillance Agent
Marshall Investigative Group —Cincinnati, OH
- $22 - $32 an hour
- Part-time
- Remote
- Microsoft Word
- 11+ years
- Research
Quick Apply
10d
Columbus - BWC Fraud Investigator - PN: 20066794
State of Ohio - Workers' Compensation —Columbus, OH
- $31.47 - $46.08 an hour
- Full-time
- Background check
- Word processing
- Mid-level
- Paid holidays
- Health insurance
5h
Anti-Fraud Manager
Central Insurance Company —Dublin, OH
- Full-time
- Hybrid work
- US work authorization
- Senior level
- 2 years
- Health insurance
Solution Architect Sr. - Fraud, Enterprise Technology
PNC Financial Services Group —Cleveland, OH
- $112,000 - $249,600 a year
- Full-time
- Computer science
- Computer Science
- Master's degree
- Wellness program
- Health savings account
Card Fraud Risk Oversight Associate
JPMorganChase —Columbus, OH
- Full-time
- Mid-level
- Office
- 3 years
- Health insurance
- Tuition reimbursement
10d
Compliance Specialist
Electronic Merchant Systems —Cleveland, OH
- From $18 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Health insurance
Quick Apply
9d
Audit Specialist
Akron Children's Hospital —Akron, OH
- Full-time
- CPA
- 5 years
- HIPAA
Surveillance Investigator
Allied Universal® Compliance and Investigations —Akron, OH
- $20 - $22 an hour
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
7d
Financial Crimes Officer II
Fifth Third Bank —Cincinnati, OH
- $82,100 - $172,500 a year
- Full-time
- 5 years
- Office
- Bachelor's degree
8d

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SIU Investigator

Centene -
Ohio

Apply Now

Job Details

Full-time
$56,200 - $101,000 a year

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Healthcare financial misconduct investigations
Health data analysis
Suspicious activity investigations
Investigative data analysis
Healthcare billing investigations
Insurance claims auditing
Healthcare claims compliance audits
Healthcare coding investigations

Full Job Description

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.

Please note: this is a remote role with preference on candidates residing within Ohio.

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, or an Associate's degree with an additional 2 years working on health care fraud, waste, and abuse investigations and audits in lieu of a Bachelors is required.
A minimum of 2 years in a health care field working on fraud, waste, and abuse investigations and audits required.
The ability to understand and analyze health care claims and coding required.

Pay Range: $56,200.00 - $101,000.00 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

Apply Now

Refine Your Search

fraud jobs in ohio

SIU Investigator

Sr. Analyst, Fraud & Investigations

Senior Investigator, Special Investigations Unit (Aetna SIU)

Fraud Risk Analyst

Operations Division Manager - Fraud Solutions-- Head of Fraud Products, Segments and Channels

Toledo - BWC Fraud Analyst - PN: 20066657

Senior Compliance Investigator

Compliance Manager

Director Fraud Strategy

Fraud Account Specialist I

Auditor/Investigator II

Surveillance Agent

Columbus - BWC Fraud Investigator - PN: 20066794

Anti-Fraud Manager

Solution Architect Sr. - Fraud, Enterprise Technology

Card Fraud Risk Oversight Associate

Compliance Specialist

Audit Specialist

Surveillance Investigator

Financial Crimes Officer II

I want to receive the latest job alert for fraud in ohio

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