Top 26 Fraud examiner Jobs in South Carolina

Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —South Carolina
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Columbia, SC
- $43,888 - $93,574 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Fraud Investigator I
United Community Bank —Greenville, SC
- $38,769 - $93,302 a year
- Weekends as needed
- 3 years
- High school diploma or GED
- Analysis skills
10d
Auditor/Investigator II
Qlarant —South Carolina
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Senior Investigator, Special Investigative Unit
Molina Healthcare —South Carolina
- $52,176.00 - $107,098.87 a year
- Full-time
- Anatomy knowledge
- Microsoft Excel
- Microsoft Outlook
- Health insurance
13d
Fraud Analyst
American Credit Acceptance —Spartanburg, SC
- Full-time
- Microsoft Excel
- Mid-level
- Office
Quick Apply
Investigator III / 61096628
State of South Carolina —Richland County, SC
- $45,300 - $55,000 a year
- Online Application
- Research
- Mid-level
- Office
- Paid holidays
- Disability insurance
4d
Fraud Agent I
United Community Bank —Greenville, SC
- $37,440 - $49,382 a year
- Weekends as needed
- High school diploma or GED
- Analysis skills
- 2 years
10d
Fraud Agent II
United Community Bank —Greenville, SC
- $38,769 - $93,302 a year
- Weekends as needed
- Mid-level
- 3 years
- High school diploma or GED
6d
Investigator, Special Investigative Unit Coding-South Carolina
Molina Healthcare —South Carolina
- $20.73 - $42.55 an hour
- Full-time
- Anatomy knowledge
- Clinic experience
- Research
- Health insurance
Fraud Data & Technology Analyst
United Community Bank —Greenville, SC
- $49,972 - $127,989 a year
- Weekends as needed
- Mid-level
- 3 years
- SQL
7h
CIP - Fraud Specialist
FIRST COMMUNITY BANK (SC) —Lexington, SC
- Full-time
- Mid-level
- Analysis skills
- Organizational skills
Quick Apply
1d
Internal Auditor
Savannah River Nuclear Solutions, LLC —Aiken, SC
- $59,040 - $82,788 a year
- CPA
- Word processing
- Research
- Paid holidays
- Disability insurance
7d
Instructor, Accounting, Finance, & Comp Office Tech - Tenure Track - Spring 2027
College of Southern Nevada —Charleston, SC
- $58,046 - $89,166 a year
- Online Application
- CPA
- Mid-level
- University
- Travel reimbursement
- Paid holidays
12h
Staff Accountant
Level Financial Group, LLC —Charleston, SC
- $50,000 - $70,000 a year
- CPA
- Mid-level
- Office
- Dental insurance
- Vision insurance
Quick Apply
Audits Manager II
State of South Carolina —Richland County, SC
- $95,000 - $115,000 a year
- Full-time
- 18 years or older
- Management
- Office
- Free parking
- Paid holidays
Senior Accountant
Level Financial Group, LLC —Columbia, SC
- $65,000 - $90,000 a year
- CPA
- Mid-level
- Office
- Dental insurance
- Vision insurance
Quick Apply
Forensic Accounting Manager
Level Financial Group, LLC —Summerville, SC
- $90,000 - $130,000 a year
- Full-time
- 7 years
- Management
- CPA
- Dental insurance
- Vision insurance
Quick Apply
Capital Projects and Real Estate Advisory Senior
Baker Tilly Advisory Group, LP —Columbia, SC
- $86,660 - $164,300 a year
- Full-time
- CPA
- Engineering
- 3 years
Quick Apply

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Forensic Accounting Manager
Level Financial Group, LLC —Summerville, SC
Bachelor's degree in Accounting, Finance, or a related field. Professional development and certification support. Supervise and train junior staff and analysts.
$90,000 - $130,000 a year
Quick Apply
Forensic Accountant, Family Law
J.S. Held LLC —Charleston, SC
Bachelor’s degree in Accounting, Finance, or a related field. Proficiency in Microsoft Excel, QuickBooks, and financial analysis tools.
$85,000 - $105,000 a year
Quick Apply

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Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Columbus, OH
The Special Investigations Unit (SIU) Investigator conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare…
$43,888 - $93,574 a year
Columbus - BWC Fraud Investigator - PN: 20066794
State of Ohio - Workers' Compensation —Columbus, OH
(Note: conducting criminal investigations is defined as performing field interviews & interrogation, field surveillance, field information & evidence gathering…
$31.47 - $46.08 an hour
5d

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fraud examiner jobs near south carolina

Senior Investigator, Special Investigations Unit (Aetna SIU)

CVS Health -
South Carolina

Apply Now

Job Details

Full-time
$46,988 - $112,200 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Healthcare financial misconduct investigations
Customer communication
Spreadsheets
Research
Suspicious activity investigations
HCPCS
Insurance investigations
Productivity software

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes.

Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business
Researches and prepares cases for clinical and legal review
Documents all appropriate case activity in case tracking system
Facilitates feedback with providers related to clinical findings
Initiates proactive data mining to identify aberrant billing patterns
Makes referrals, both internal and external, in the required timeframe
Facilitates the recovery of company and customer money lost as a result of fraud matters
Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators.
Assists Investigators in identifying resources and best course of action on investigations
Serves as back up to the Team Leader as necessary
Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters.
Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings
Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud
Provides input regarding controls for monitoring fraud related issues within the business units

Required Qualifications

3+ years investigative experience in the area of healthcare fraud and abuse matters.

Working knowledge of medical coding; CPT, HCPCS, ICD10
Experience with Microsoft Office with advanced skills in Excel (must know how to do pivot tables).
Ability to travel up to 10% (approx. 2-3x per year, depending on business needs)

Preferred Qualifications

Previous Medicaid/Medicare investigatory experience
Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse.
Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI)
Knowledge of Aetna's policies and procedures.
Knowledge and understanding of complex clinical issues.
Competent with legal theories.
Strong communication and customer service skills.
Ability to effectively interact with different groups of people at different levels in any situation.
Strong analytical and research skills.
Proficient in researching information and identifying information resources.
Strong verbal and written communication skills.

Education:

Bachelor's degree or equivalent experience (3+ years of working health care fraud, waste and abuse investigations).

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/01/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

fraud examiner jobs in south carolina

Senior Investigator, Special Investigations Unit (Aetna SIU)

Investigator, Special Investigations Unit (Aetna SIU)

Fraud Investigator I

Auditor/Investigator II

Senior Investigator, Special Investigative Unit

Fraud Analyst

Investigator III / 61096628

Fraud Agent I

Fraud Agent II

Investigator, Special Investigative Unit Coding-South Carolina

Fraud Data & Technology Analyst

CIP - Fraud Specialist

Internal Auditor

Instructor, Accounting, Finance, & Comp Office Tech - Tenure Track - Spring 2027

Staff Accountant

Audits Manager II

Senior Accountant

Forensic Accounting Manager

Capital Projects and Real Estate Advisory Senior

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