Top 127 Insurance fraud investigator Jobs in California

SIU Investigator
Centene —California
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Fair chance
- Paid holidays
- Health insurance
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Sacramento, CA
- $46,988 - $112,200 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
2d
Senior Compliance Investigator
Centene —California
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Fraud Investigator
TikTok —San Jose, CA
- $121,600 - $220,400 a year
- Finance
- Analysis skills
- Case management
- Paid parental leave
- Paid holidays
Sr. Fraud Investigation Associate
Hyundai Capital America —Irvine, CA
- $80,000 - $120,000 a year
- Full-time
- Writing skills
- Research
- Office
- Health savings account
- Disability insurance
11d
Senior Investigator Pharmacy - Los Angeles County, CA
UnitedHealthcare —Los Angeles, CA
- $60,200 - $107,400 a year
- Full-time
- Remote
- Microsoft Word
- Up to 50% travel
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Compliance Investigator II
Partnership HealthPlan of California —Fairfield, CA
- $96,970.04 - $121,212.56 a year
- Full-time
- Microsoft Excel
- HIPAA
- Office
Trial Attorney (Hybrid)
Abramson Labor Group —Burbank, CA
- $200,000 - $300,000 a year
- Full-time
- Hybrid work
- Analysis skills
- Computer skills
- Senior level
- Health insurance
- Paid time off
Quick Apply
Trial Attorney
Abramson Labor Group —Burbank, CA
- $200,000 - $300,000 a year
- Full-time
- Remote
- Analysis skills
- Computer skills
- Senior level
- Health insurance
- Paid time off
Quick Apply
Trial Attorney (Remote) - Must Reside in California
Abramson Labor Group —Burbank, CA
- $200,000 - $300,000 a year
- Full-time
- Remote
- Analysis skills
- Computer skills
- Senior level
- Health insurance
- Paid time off
Quick Apply
Auto Liability Claim Rep
Travelers —Diamond Bar, CA
- $67,000 - $110,600 a year
- Mid-level
- Analysis skills
- Bachelor's degree
- Wellness program
- Paid holidays
12d
General Liability Senior Technical Specialist
Travelers —Diamond Bar, CA
- $94,400 - $155,800 a year
- Hybrid work
- Residential
- High school diploma or GED
- Analysis skills
- Wellness program
- Continuing education credits
12d
INVESTIGATOR
Department of Insurance —Los Angeles County, CA
- $6,339 - $10,609 a month
- Full-time
- Hybrid work
- Background check
- Writing skills
- Mid-level
- Free parking
- Wellness program
Senior Financial Investigator
Contact Government Services, LLC —Los Angeles, CA
- $74,156.16 - $107,114.45 a year
- Full-time
- Hybrid work
- Mid-level
- Driver's License
- Presentation skills
- Health insurance
- Dental insurance
Quick Apply
INVESTIGATOR
Department of Consumer Affairs —Santa Clara County, CA
- $6,339 - $10,609 a month
- Weekends as needed
- Hybrid work
- Pass drug screening
- Mid-level
- Office
Entry-Level Investigator
Ethos Risk Services —Riverside, CA
- From $22 an hour
- Weekends as needed
- Computer literacy
- Writing skills
- No experience needed
- Paid training
- Mileage reimbursement
Quick Apply
10d
INVESTIGATOR
Department of Health Care Services —Sacramento County, CA
- $6,339 - $10,609 a month
- Online Application
- Hybrid work
- Bilingual
- Writing skills
- Pass drug screening
- Paid holidays
- Dental insurance
12d
Affirmative Civil Enforcement (ACE) Investigator
Contact Government Services, LLC —Los Angeles, CA
- $51,435.30 - $66,131.10 a year
- Full-time
- Hybrid work
- Microsoft Access
- Microsoft Outlook
- Office
- Health insurance
- Dental insurance
Quick Apply
Corporate Investigator, Enterprise Protection Program - Global Investigations
Amazon.com Services LLC —Sunnyvale, CA
- $80,200 - $143,100 a year
- Full-time
- Customer service
- Mid-level
- Office
- AD&D insurance
- Health insurance
Commercial Bank Fraud Investigator
Avidbank —San Jose, CA
- $65,000 - $100,000 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply

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insurance fraud investigator jobs near california

SIU Investigator

Centene -
California

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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
Data mining
Health data analysis
Bachelor's degree in business
Mid-level
Suspicious activity investigations
Data summary reports
Criminal Justice
Audit Reporting
Investigative data analysis
Analysis skills
Insurance investigation report preparation
Outlier detection
Healthcare billing investigations
Case referral
1 year
Insurance claims auditing
Query management
Business
Healthcare claims compliance audits
Bachelor's degree in criminal justice

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: Candidates must reside within the state of California*

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 required. 1+ years of medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation experience 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

insurance fraud investigator jobs in california

SIU Investigator

Senior Investigator, Special Investigations Unit (Aetna SIU)

Senior Compliance Investigator

Fraud Investigator

Sr. Fraud Investigation Associate

Senior Investigator Pharmacy - Los Angeles County, CA

Compliance Investigator II

Trial Attorney (Hybrid)

Trial Attorney

Trial Attorney (Remote) - Must Reside in California

Auto Liability Claim Rep

General Liability Senior Technical Specialist

INVESTIGATOR

Senior Financial Investigator

INVESTIGATOR

Entry-Level Investigator

INVESTIGATOR

Affirmative Civil Enforcement (ACE) Investigator

Corporate Investigator, Enterprise Protection Program - Global Investigations

Commercial Bank Fraud Investigator

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