Top 158 Fraud investigator Jobs in Florida

SIU Investigator
Centene —Florida
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Investigative Analyst/ Investigator Trainee
TIG Risk Services —Destin, FL
- From $18 an hour
- Full-time
- Computer literacy
- Office
- Microsoft Office
- Paid training
- Health insurance
Quick Apply
Surveillance Investigator II - Experienced
Command Investigations, LLC —Pensacola, FL
- $25 - $30 an hour
- 8 hour shift
- Microsoft Word
- Background check
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
Private Investigator
Summers Private Investigations, Inc —Orlando, FL
- $25 - $40 an hour
- Part-time
- Mid-level
- In-person
- 2 years
Quick Apply
Auditor/Investigator II
Qlarant —Florida
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Corporate Ethics & Compliance Investigator
Centene —Florida
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Florida
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
7d
Investigator, Special Investigative Unit-must reside in Florida
Molina Healthcare —Florida
- $21.82 - $42.55 an hour
- Full-time
- Anatomy knowledge
- Customer service
- Research
- Health insurance
Senior Compliance Investigator
Centene —Florida
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Fraud, Waste and Abuse Investigation, Senior Analyst
CVS Health —Florida
- $46,988 - $112,200 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
SIU Expert Investigator
Kemper Insurance —Miami, FL
- $70,000 - $117,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Management
Quick Apply
Manager, SIU Prepay Investigations
Centene —Florida
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Supervising experience
- Paid holidays
- Health insurance
Senior Field Security Investigator
GEICO —Orlando, FL
- $32.05 - $49.86 an hour
- Full-time
- 5 years
- Senior level
- Associate's degree
14d
Senior Financial Investigator
Contact Government Services, LLC —Tampa, FL
- $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
SIU Desk Investigator - Miami
AssuranceAmerica —Florida
- Full-time
- Mid-level
- Office
- Finance
Surveillance Investigator
VRC Investigations —Port Saint Lucie, FL
- Clean driving record
- Military
- Computer literacy
- Profit sharing
- Paid training
Quick Apply
Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home
The Cigna Group —Miami, FL
- Online Application
- Remote
- Spanish
- Analysis skills
- Conflict management
Asset Protection Investigator
Neiman Marcus —Orlando, FL
- $21.53 - $30.94 an hour
- Full-time
- Computer literacy
- Writing skills
- Conflict management
- Disability insurance
- Health insurance
2d
SIU Desk Investigator - Tampa
AssuranceAmerica —Tampa, FL
- Full-time
- Mid-level
- Office
- Finance
13d
Senior Internal Investigator Lakeland
GEICO —Lakeland, FL
- Full-time
- Office
- Mentoring
- Senior level
1d

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fraud investigator jobs near florida

SIU Investigator

Centene -
Florida

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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
Insurance investigation report preparation
Outlier detection
Healthcare billing investigations
Case referral
1 year
Insurance claims auditing
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 who reside in Florida are highly preferred.

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 Business, Criminal Justice, Healthcare, or related field, or equivalent experience required
1+ years Medical claim investigation, medical claim audit, medical claim analysis, or fraud investigation 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 investigator jobs in florida

SIU Investigator

Investigative Analyst/ Investigator Trainee

Surveillance Investigator II - Experienced

Private Investigator

Auditor/Investigator II

Corporate Ethics & Compliance Investigator

Senior Investigator, Special Investigations Unit (Aetna SIU)

Investigator, Special Investigative Unit-must reside in Florida

Senior Compliance Investigator

Fraud, Waste and Abuse Investigation, Senior Analyst

SIU Expert Investigator

Manager, SIU Prepay Investigations

Senior Field Security Investigator

Senior Financial Investigator

SIU Desk Investigator - Miami

Surveillance Investigator

Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home

Asset Protection Investigator

SIU Desk Investigator - Tampa

Senior Internal Investigator Lakeland

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