Top 75 Insurance fraud investigator Jobs in Texas

SIU Investigator
Centene —Texas
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Corporate Ethics & Compliance Investigator
Centene —Texas
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
Senior Investigator
UnitedHealthcare —Dallas, TX
- $60,200 - $107,400 a year
- Full-time
- Remote
- Microsoft Word
- Pass drug screening
- Driver's License
- AD&D insurance
- Employee stock purchase plan
Senior Compliance Investigator
Centene —Texas
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Texas
- $46,988 - $112,200 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
SIU Investigator (Remote)
Crum & Forster —Austin, TX
- $78,900 - $115,700 a year
- Remote
- 6 years
- Computer literacy
- Writing skills
- Employee stock purchase plan
- Health insurance
2d
Senior Financial Investigator
Contact Government Services, LLC —Dallas, TX
- $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
CBRE —Dallas, TX
- $120,000 - $150,000 a year
- Full-time
- Master's degree
- 8 years
- Analysis skills
- Health insurance
- Dental insurance
Anti-Fraud Manager
Central Insurance Company —Irving, TX
- Full-time
- Hybrid work
- US work authorization
- Senior level
- 2 years
- Health insurance
Surveillance Agent
Marshall Investigative Group —Midland, TX
- $22 - $32 an hour
- Part-time
- Remote
- Microsoft Word
- 11+ years
- Research
Quick Apply
11d
Transaction Monitoring Investigator
Guidehouse Managed Services LLC —Lewisville, TX
- Full-time
- Research
- Mid-level
- Office
- Health savings account
- Paid holidays
FT Private Investigator- Houston, TX
Delta Group —Houston, TX
- $20 - $30 an hour
- Full-time
- Remote
- Background check
- 18 years or older
- Clean driving record
- Disability insurance
- Health insurance
3d
Investigator, Special Investigations Unit (Meritain Health)
CVS Health —Austin, TX
- $46,988 - $122,400 a year
- Full-time
- Customer service
- Research
- Mid-level
- Health insurance
- Dental insurance
2d
Investigator II
Health & Human Services Comm —Austin, TX
- $3,409.83 - $5,094.16 a month
- Overtime
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Opportunities for advancement
Quick Apply
Investigator I
Health & Human Services Comm —Austin, TX
- $3,095.33 - $4,594.50 a month
- Overtime
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Opportunities for advancement
Quick Apply
Transaction Monitoring Investigator
Guidehouse —San Antonio, TX
- Research
- Mid-level
- Office
- Health savings account
- Paid holidays
Investigator
Ethos Risk Services —Lubbock, TX
- $28 - $38 an hour
- Part-time
- Mid-level
- Residential
- Driver's License
- Paid time off
- Referral program
Quick Apply
SIU Investigator
ORIGIN INVESTIGATIONS —Houston, TX
- $25 - $40 an hour
- Full-time
- Mid-level
- Analysis skills
- Travel
- Mileage reimbursement
- Health insurance
Quick Apply
11d
Senior Analyst - Payment Integrity Analytics
Gainwell Technologies —Texas
- $69,400 - $99,200 a year
- Full-time
- Presentation skills
- Travel
- Senior level
- Travel reimbursement
- Profit sharing
General Liability - Technical Specialist
The Travelers Companies, Inc. —Richardson, TX
- $85,600 - $141,200 a year
- Hybrid work
- Mid-level
- Analysis skills
- Bachelor's degree
- Wellness program
- Continuing education credits

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insurance fraud investigator jobs near texas

SIU Investigator

Centene -
Texas

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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: this is a remote role with preference on candidates located in Texas.

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 texas

SIU Investigator

Corporate Ethics & Compliance Investigator

Senior Investigator

Senior Compliance Investigator

Senior Investigator, Special Investigations Unit (Aetna SIU)

SIU Investigator (Remote)

Senior Financial Investigator

Investigator

Anti-Fraud Manager

Surveillance Agent

Transaction Monitoring Investigator

FT Private Investigator- Houston, TX

Investigator, Special Investigations Unit (Meritain Health)

Investigator II

Investigator I

Transaction Monitoring Investigator

Investigator

SIU Investigator

Senior Analyst - Payment Integrity Analytics

General Liability - Technical Specialist

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