Top 88 Insurance 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
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
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- 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
Senior Field Security Investigator
GEICO —Orlando, FL
- $32.05 - $49.86 an hour
- Full-time
- 5 years
- Senior level
- Associate's degree
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Tallahassee, FL
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
3d
Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home
The Cigna Group —Miami, FL
- Online Application
- Remote
- Spanish
- Analysis skills
- Conflict management
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
Associate II, Inspector General
Confidential —West Palm Beach, FL
- $50,990 - $79,318 a year
- Full-time
- Hybrid work
- Background check
- CPA
- Pass drug screening
- Wellness program
- Paid holidays
4d
Major Case Specialist, Construction Defect
Travelers —Tampa, FL
- $104,000 - $171,700 a year
- Customer service
- 3 years
- High school diploma or GED
- Wellness program
- Paid holidays
7d
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
Affirmative Civil Enforcement (ACE) Investigator
Contact Government Services, LLC —Tampa, FL
- $51,435.30 - $66,131.10 a year
- Full-time
- Hybrid work
- Microsoft Access
- Microsoft Outlook
- Office
- Health insurance
- Dental insurance
Quick Apply
SIU Desk Investigator - Miami
AssuranceAmerica —Florida
- Full-time
- Mid-level
- Office
- Finance
SIU Investigator (Part-Time)
VRC Investigations —Tallahassee, FL
- Part-time
- Customer service
- 5 years
- Military
- Profit sharing
- Paid training
Quick Apply
SIU Desk Investigator - Tampa
AssuranceAmerica —Tampa, FL
- Full-time
- Mid-level
- Office
- Finance
Principal, Legal Compliance (Ethics & Compliance Officer)
L3Harris Technologies —Melbourne, FL
- $115,500 - $247,000 a year
- Bachelor's degree
- Travel
- Organizational skills
- Paid holidays
- Disability insurance
Sanctions Risk Specialist, GBS - Denied Party Screening
Amazon.com Services LLC —Florida
- $55,600 - $97,400 a year
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- AD&D insurance
- Health insurance
Investigator
Ethos Risk Services —Fort Walton Beach, FL
- $25 - $35 an hour
- Part-time
- Mid-level
- Residential
- Driver's License
- Paid time off
- Referral program
Quick Apply
5d
SIU Investigator - Miami, FL
Delta Group —Miami, FL
- $30 - $40 an hour
- Per diem
- Microsoft Outlook
- Organizational skills
- Senior level
Quick Apply
14d
Investigator, Special Investigative Unit Coding-Miami Florida
Molina Healthcare —Florida
- $21.82 - $42.55 an hour
- Full-time
- Anatomy knowledge
- Clinic experience
- Research
- Health insurance

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insurance fraud investigator jobs near florida

SIU Investigator

Centene -
Florida

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
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

insurance fraud investigator jobs in florida

SIU Investigator

Corporate Ethics & Compliance Investigator

Senior Investigator, Special Investigations Unit (Aetna SIU)

SIU Expert Investigator

Senior Field Security Investigator

Investigator, Special Investigations Unit (Meritain Health)

Bilingual Junior Healthcare Fraud Investigator-Florida Work at Home

Senior Compliance Investigator

Associate II, Inspector General

Major Case Specialist, Construction Defect

Senior Financial Investigator

Affirmative Civil Enforcement (ACE) Investigator

SIU Desk Investigator - Miami

SIU Investigator (Part-Time)

SIU Desk Investigator - Tampa

Principal, Legal Compliance (Ethics & Compliance Officer)

Sanctions Risk Specialist, GBS - Denied Party Screening

Investigator

SIU Investigator - Miami, FL

Investigator, Special Investigative Unit Coding-Miami Florida

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