Top 69 Fraud examiner Jobs in Georgia

SIU Investigator
Centene —Georgia
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Auditor/Investigator II
Qlarant —Georgia
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Georgia
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
4d
Senior Internal Security Investigator (Remote)
GEICO —Atlanta, GA
- $32.05 - $57.49 an hour
- 8 hour shift
- Remote
- 5 years
- Analysis skills
- Bachelor's degree
3d
Fraud, Waste and Abuse Investigation, Senior Analyst
CVS Health —Georgia
- $46,988 - $112,200 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Healthcare Fraud Investigator
Contact Government Services, LLC —Atlanta, GA
- $85,000 - $105,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Mid-level
- 3 years
Quick Apply
Investigator - Medicaid Fraud
Georgia Office of the Attorney General —Atlanta, GA
- From $50 an hour
- Email
- Mid-level
- Finance
- Analysis skills
Supervisor - Audit/Investigation
Qlarant —Georgia
- $66,285 - $95,000 a year
- Full-time
- Remote
- Bachelor's degree
- Senior level
Senior Compliance Investigator
Centene —Georgia
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Internal Auditor
Georgia Lottery Corporation —Atlanta, GA
- $80,000 - $90,000 a year
- Full-time
- CPA
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Investigator - Medicaid Fraud - Criminal
Georgia Office of the Attorney General —Atlanta, GA
- $60 an hour
- Email
- Mid-level
- Analysis skills
- Criminal background check
Merchant Risk Monitoring Investigator
Upgrade —Atlanta, GA
- English
- Research
- 3 years
- Paid parental leave
- Health insurance
Quick Apply
Special Agent
National Insurance Crime Bureau —Atlanta, GA
- $66,750 a year
- Full-time
- Mid-level
- 3 years
- Driver's License
- 401(k)
- Paid time off
Quick Apply
SIU Investigator
Allied Universal® Compliance and Investigations —Kennesaw, GA
- Weekends as needed
- Military
- Computer literacy
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
14d
Assistant Director
Focus People, Inc. —Atlanta, GA
- $105,000 a year
- Full-time
- Microsoft Word
- CPA
- Research
Quick Apply
Enterprise Insider Threat Principal Analyst (Atlanta, Charlotte, Greensboro) - W2 ONLY
Matlen Silver —Atlanta, GA
- Contract
- 7 years
- Computer Science
- Analysis skills
Quick Apply
5d
SIU Investigator
Allied Universal® Compliance and Investigations —McDonough, GA
- Weekends as needed
- Military
- Computer literacy
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
14d
SIU Investigator
Allied Universal® Compliance and Investigations —LaGrange, GA
- Weekends as needed
- Military
- Computer literacy
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
14d
Consultant - Anti-Money Laundering - Financial Crime and Fraud
Deloitte —Atlanta, GA
- $78,700 - $155,100 a year
- Full-time
- Mid-level
- Finance
- Analysis skills
3d
Insider Threat Investigator
Workday —Atlanta, GA
- $144,400 - $228,000 a year
- Full-time
- Office
- 8 years
- Fair chance
- Flexible schedule
4d

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SIU Investigator

Centene -
Georgia

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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
Certified Fraud Examiner
Mid-level
Suspicious activity investigations
Data summary reports
Criminal Justice
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.

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. Strong Excel skills preferred. CFE (Certified Fraud Examiner) preferred.

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 examiner jobs in georgia

SIU Investigator

Auditor/Investigator II

Senior Investigator, Special Investigations Unit (Aetna SIU)

Senior Internal Security Investigator (Remote)

Fraud, Waste and Abuse Investigation, Senior Analyst

Healthcare Fraud Investigator

Investigator - Medicaid Fraud

Supervisor - Audit/Investigation

Senior Compliance Investigator

Internal Auditor

Investigator - Medicaid Fraud - Criminal

Merchant Risk Monitoring Investigator

Special Agent

SIU Investigator

Assistant Director

Enterprise Insider Threat Principal Analyst (Atlanta, Charlotte, Greensboro) - W2 ONLY

SIU Investigator

SIU Investigator

Consultant - Anti-Money Laundering - Financial Crime and Fraud

Insider Threat Investigator

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