Top 32 Fraud investigator Jobs in Arizona

Lead SIU Investigator
Centene —Arizona
- $70,100 - $126,200 a year
- Full-time
- Remote
- Master's degree
- High school diploma or GED
- Mentoring
- Paid holidays
- Health insurance
Special Investigations Field - Investigator I
The Cincinnati Insurance Companies —Phoenix, AZ
- $60,000 - $88,000 a year
- Hybrid work
- 5 years
- Public speaking
- Senior level
- Work from home
2h
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Phoenix, AZ
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
Compliance Investigator
District Support Services Center —Tempe, AZ
- $69,538.50 - $90,400.05 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Wellness program
- 403(b) matching
Program Integrity Investigator (Healthcare Fraud Waste & Abuse)
TriWest Healthcare Alliance —Phoenix, AZ
- $64,000 - $68,000 a year
- Full-time
- Customer service
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Fraud Investigation, Associate / AVP Team Lead
MUFG —Tempe, AZ
- $82,000 - $106,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Office
- Paid parental leave
- Paid holidays
3d
Senior Compliance Investigator
Centene —Arizona
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
14d
FINANCIAL INVESTIGATOR
State of Arizona —Phoenix, AZ
- $60,000 - $89,000 a year
- Full-time
- CPA
- Writing skills
- Research
- Paid holidays
- Disability insurance
Sr. Insurance Fraud Analyst
Tesla —Tucson, AZ
- Full-time
- 3 years
- SQL
- Analysis skills
- Commuter assistance
- Health savings account
Field Investigator (Full-Time & Part-Time) – Phoenix, AZ
Origin Investigations Inc —Phoenix, AZ
- $25 - $35 an hour
- Part-time
- Background check
- Military
- Computer literacy
Quick Apply
Sr. SIU Investigator, Major Case
Tesla —Tucson, AZ
- Full-time
- 3 years
- Analysis skills
- Bachelor's degree
- Commuter assistance
- Health savings account
Consultant, Financial Crimes Investigator
Northern Trust Corp. —Tempe, AZ
- Full-time
- Research
- Windows
- Analysis skills
Experienced AML Investigator - Financial Crimes (Hybrid)
AML RightSource, LLC —Phoenix, AZ
- $43,888 - $69,000 a year
- Full-time
- Hybrid work
- Mid-level
- Analysis skills
- Bachelor's degree
- Paid holidays
- Dental insurance
Quick Apply
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —Arizona
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
Surveillance Investigator
Lemieux & Associates LLC —Phoenix, AZ
- $25 - $32 an hour
- Part-time
- Bilingual
- Microsoft Word
- Computer literacy
- Flexible schedule
Quick Apply
Field Investigator
Advantage Surveillance LLC —Phoenix, AZ
- $20 - $25 an hour
- Weekends as needed
- Clean driving record
- Pass drug screening
- Driving
- Travel reimbursement
- Paid parental leave
Quick Apply
2d
Internal Audit Manager
State of Arizona —Phoenix, AZ
- $72,099 - $75,750 a year
- Full-time
- Microsoft Excel
- CPA
- Writing skills
- Paid parental leave
- Paid holidays
SIU Investigator
Allied Universal® Compliance and Investigations —Mesa, AZ
- Weekends as needed
- Military
- Computer literacy
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
5d
Surveillance Investigator
Allied Universal® Compliance and Investigations —Phoenix, AZ
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
11d
Claims Investigator - Part Time
Command Investigations, LLC —Phoenix, AZ
- $23 - $30 an hour
- Overtime
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
Quick Apply

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fraud investigator jobs near arizona

Lead SIU Investigator

Centene -
Arizona

Apply Now

Job Details

Full-time
$70,100 - $126,200 a year

Benefits

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

Qualifications

Healthcare financial misconduct investigations
Investigations regulatory compliance
Medicare
Medical law
Managed care
Managed care organization experience
Health insurance policy knowledge
Regulatory legal research
Medicare regulations
Insurance investigations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid

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.

*This is a remote role anywhere within the continental US.*

Position Purpose: Position acts as a subject matter expert in the field of Special Investigations Unit (SIU) investigations. Provides direction and guidance to staff who investigate and remediate compliance and fraud, waste, and abuse related matters; while maintaining an investigative workload of moderate to high complexity. Assists manager on monitoring team caseload and report on metrics.

Provides guidance to team members who investigate and remediate compliance and fraud, waste, and abuse related matters.
Assists manager on monitoring team caseload and report on metrics.
Identifies training needs and develop training aids and step actions.
Provides training and mentoring to team on casework and other SIU activities.
Evaluates and assesses allegations to determine those criteria, including federal and state regulations, Centers for Medicare & Medicaid Services (“CMS”) guidelines, and internal policies, procedures, and standards that are alleged to have been violated.
Conducts and documents interviews investigatory purposes.
Reviews investigative interviews prepared by junior investigators.
Manages caseloads of moderate to high complexity, develops investigative plans for multiple investigations, prioritizing and managing through execution.
Thoroughly documents actions, organizes, and reviews case files.
Consults with management, in-house counsel, and/or senior leadership to resolve difficult or complex issues.
Identifies risks and recommends and communicates remedial actions to mitigate future potential risks.
Performs follow up to ensure remedial and disciplinary measures are implemented appropriately and timely.
Prepares clear and concise investigative plans and reports.
Provides support and guidance to junior investigative staff.
Identifies trends and aberrant activity to generate proactive leads for investigations and analyzes data to detect potentially fraudulent activity.
Attends, actively participates in, and/or leads meetings with various business area managers.
Communicates directly with Federal or State regulators.
Prepares cases for referral to management, government agencies, and law enforcement.
Develops and maintains strong working relationships with associates and regulators.
Testifies in criminal and civil matters.
Participates in and lead special projects as needed.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience:

Bachelor's Degree in related field; or Associate's degree with 6 years related experience; or High School Diploma/GED with 7 years related experience. required.
Master's Degree preferred.
5+ years Healthcare fraud-related investigations with audit and risk analysis required.
1+ years Managed care or working with health insurance company required.
In-depth knowledge of government programs, the managed care industry, Medicare, Medicate laws and requirements, federal, state, civil and criminal statutes required.
Reading, analyzing and interpreting State and Federal laws, rules and regulations. Knowledge of community, state and federal laws and resources required.
Knowledge and understanding of managed care claims processing systems and medical claims coding preferred preferred.

Licenses/Certifications:

Accredited Health Care Fraud Investigator (AHFI), Certified Fraud Examiner (CFE) or other industry related certification preferred.

Pay Range: $70,100.00 - $126,200.00 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 investigator jobs in arizona

Lead SIU Investigator

Special Investigations Field - Investigator I

Investigator, Special Investigations Unit (Meritain Health)

Compliance Investigator

Program Integrity Investigator (Healthcare Fraud Waste & Abuse)

Fraud Investigation, Associate / AVP Team Lead

Senior Compliance Investigator

FINANCIAL INVESTIGATOR

Sr. Insurance Fraud Analyst

Field Investigator (Full-Time & Part-Time) – Phoenix, AZ

Sr. SIU Investigator, Major Case

Consultant, Financial Crimes Investigator

Experienced AML Investigator - Financial Crimes (Hybrid)

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Surveillance Investigator

Field Investigator

Internal Audit Manager

SIU Investigator

Surveillance Investigator

Claims Investigator - Part Time

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