Top 15 Fraud Jobs in Lansing, Mi

Special Investigations Unit Investigator
Delta Dental of Michigan —Okemos, MI
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Dental insurance
- Opportunities for advancement
2d
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Lansing, MI
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
Surveillance Investigator
Allied Universal® Compliance and Investigations —Lansing, MI
- Weekends as needed
- Microsoft Word
- Military
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
1d
Supervisor, Special Investigations Unit Operations
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
Account Fraud Manager
MSU Federal Credit Union —East Lansing, MI
- $90,000 - $110,000 a year
- Monday to Friday
- Hybrid work
- Computer literacy
- Mid-level
- Office
- Paid parental leave
- Paid holidays
Quick Apply
14d
SIU Claims Investigator
Lemieux & Associates LLC —Lansing, MI
- $25 - $32 an hour
- Part-time
- Bilingual
- Computer literacy
- Mid-level
- Flexible schedule
Quick Apply
Private Investigator - Retired/Former Law Enforcement
Lemieux & Associates LLC —Lansing, MI
- $25 - $30 an hour
- Part-time
- Bilingual
- Computer literacy
- Mid-level
- Mileage reimbursement
Quick Apply
Specialty Banking Risk & Compliance Analyst I
Dart Bank —Mason, MI
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Health insurance
- Dental insurance
Financial Crimes Compliance AML Investigator (Contractor)
Dart Bank —Mason, MI
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Profit sharing
- Health insurance
9d
As Needed Field Investigator- Lansing, MI
J T Becker & Co Inc —Lansing, MI
- Writing skills
- Mid-level
- Driver's License
- Flexible schedule
Quick Apply
Sales Executive - Financial Crimes Solutions
Jack Henry & Associates —United States
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree

More jobs to discover

Find similar jobs that you might be interested in.

Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Lansing, MI
The SIU Investigator will conduct investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover…
$46,988 - $122,400 a year

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Fraud and Abuse Investigator / CPC - Remote
Sentara Workforce Solutions, LLC —Columbus, OH
Keywords: Healthcare, Health Plan, Remote, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada,…
$25.60 - $42.67 an hour
Quick Apply
1d
Fraud Analyst
Northwest Bank —Columbus, OH
Ability to establish courses of action for self to accomplish specific goals, develop and use tracking systems for monitoring own work progress, and effectively…
Quick Apply
9d

Show more jobs in cities nearby

I want to receive the latest job alert for fraud in lansing, mi

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

fraud jobs near lansing, mi

Health Unit Coordinator jobs in Lansing, MI

Field Investigator jobs in Woodbridge, VA

Field Investigator jobs in Kansas City, MO

Field Investigator jobs in North Carolina

Field Investigator jobs in St. Louis, MO

Lincoln Financial Field jobs in Philadelphia, PA

Surveillance Investigator jobs in Buena Park, CA

Private Investigator jobs in Maryland

Private Investigator jobs in Massachusetts

Fraud Investigator jobs in Richmond, VA

Surveillance Investigator jobs in Pittsburgh, PA

Surveillance Investigator jobs in San Antonio, TX

Surveillance Investigator jobs in Marietta, GA

Chief Finance Officer jobs in Jacksonville, FL

Security Officer jobs in Olathe, KS

Compliance Officer jobs in Corona, CA

Compliance Officer jobs in Nashville, TN

Security Officer jobs in Houston, TX

Compliance Officer jobs in Omaha, NE

Compliance Officer jobs in City Of Chicago, IL

Special Investigations Unit Investigator

Delta Dental of Michigan -
Okemos, MI

Apply Now

Job Details

Full-time
2 days ago

Benefits

Dental insurance
Opportunities for advancement

Qualifications

Data mining
Dental terminology
Bachelor's degree
Financial data analysis tools
Data analysis software

Full Job Description

Job Title:

Special Investigations Unit Investigator

Number of Positions:

Location:

Okemos, MI

Location Specifics:

Fully Remote

Job Summary:

Candidates must reside in Michigan within a reasonable commuting distance of our Okemos, MI office for team meetings, collaborative sessions, and training.

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Position Description:

Responsible for the research and reporting of internal and external activities of providers and members involved in questionable conduct as it pertains to treatment patterns, claim submissions, contract agreements, and state licensing requirements.

Primary Job Responsibilities:

Plans, coordinates, prepares, and performs in-depth provider and member audits, and researches questionable conduct using data extraction and analysis tools and techniques.
Conducts interviews, requests and preserves evidence, reviews auditee’s treatment and financial records, controls, and other pertinent records.
Prepares written communications to the auditee and mid to senior level management, including requests, audit reports and general correspondence to ensure compliance with contracts or state licenses.
Educates providers and members regarding contractual requirements in order to gain or maintain compliance with participating agreements, client contracts, and applicable laws and regulations.
Provides assistance to law enforcement agencies or attorneys in the detection, defense, and prosecution of fraud, to include responding to subpoenas, preparing documentation, and testifying in administrative or judicial proceedings regarding violations of contracts.
Makes recommendations to enhance system controls and contract agreements in order assist in preventing aberrant behavior.
Develops training programs and educates corporate staff in Anti-Fraud activities.
Assists in implementing, supporting, developing and maintaining relationships with Delta Dental affiliates.

Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

#LI-Remote

Minimum Requirements:

Position requires a bachelor's degree in accounting, business administration, finance, healthcare administration, information technology, or a related field and three years of experience auditing, utilizing analytical tools and software, dental claims billing or review, or as a dental hygienist. Will accept any suitable combination of education, training, or experience.

Position requires advanced knowledge of dental terminology and dental procedure codes; knowledge of common data mining tools, such as Audit Command Language (ACL), SQL Developer and IBM’s Fraud and Abuse Management System (FAMS); strong verbal and written communication skills; strong organizational and analytical skills; ability to manage multiple assignments with competing deadlines; and the ability to resolve complex problems using independent judgment.

An Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), or Certified Internal Auditor (CIA) designation is preferred.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

Apply Now

Refine Your Search

fraud jobs in lansing, mi

Special Investigations Unit Investigator

Investigator, Special Investigations Unit (Meritain Health)

Surveillance Investigator

Supervisor, Special Investigations Unit Operations

Account Fraud Manager

SIU Claims Investigator

Private Investigator - Retired/Former Law Enforcement

Specialty Banking Risk & Compliance Analyst I

Financial Crimes Compliance AML Investigator (Contractor)

As Needed Field Investigator- Lansing, MI

Sales Executive - Financial Crimes Solutions

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for fraud in lansing, mi

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected