Investigate known or suspected fraud, waste, and abuse with high autonomy.
Develop documentation and reports to substantiate findings and support recoupments.
Analyze prior cases to improve preventive identification and meet savings targets.
Oscar is a health insurance company built around a full-stack technology platform and focused on serving members. The company fosters an inclusive culture where employees can be their authentic selves, with a mission to change health care.
Lead healthcare fraud lead and case development, turning analytic leads from VA's Palantir platform into decision-ready War Room referral packages.
Build referral packages with documentation supporting administrative actions and weekly decision packages for executive-level audiences.
Collaborate with OIC staff, VA OIG, and VHA stakeholders while supporting knowledge transfer and process improvement.
Arlo Solutions is an information technology consulting services company that specializes in delivering technology solutions. The company focuses on quality, value-added solutions that reduce costs, improve business processes, and support federal clients.
Lead and conduct comprehensive internal investigations into allegations of fraud, misconduct, and violations of company policy or law.
Collaborate with HR, Legal, and Compliance to gather information and employ forensic analysis to uncover facts.
Prepare detailed investigation reports and recommend corrective actions to prevent future occurrences.
Binance is a leading global blockchain ecosystem behind the world's largest cryptocurrency exchange, offering products from trading and finance to education and Web3. We are trusted by 300+ million people in 100+ countries and thrive in a results-driven workplace with a flat structure and world-class talent.
Lead and conduct internal investigations into fraud, misconduct, and policy violations.
Collaborate with HR, Legal, and Compliance to gather evidence and apply forensic techniques.
Evaluate internal controls during audits and recommend value-added improvements.
Binance is a leading global blockchain ecosystem behind the world's largest cryptocurrency exchange. Trusted by 300+ million users across 100+ countries, it fosters a user-centric, flat-structured culture.
Investigate potential payment inaccuracies using Medicare Advantage claims and reimbursement knowledge to interpret data and explain payment outcomes.
Review claims populations identified through SQL analysis, distinguishing supported discrepancies from exceptions and correctly adjudicated claims.
Document validated findings clearly and support downstream recovery, Compliance/Legal review, and recurring audits.
Clover Health provides healthcare plans for seniors, using data and technology to improve care and lower costs. The company is a remote-first, mission-driven organization focused on diversity and inclusion.
Evaluate, investigate, and resolve complex commercial property insurance claims, focusing on losses exceeding $500,000.
Manage claims from assignment through final resolution, including coverage review, reserve adjustments, and settlement negotiations.
Collaborate with independent adjusters, legal counsel, and internal stakeholders while ensuring regulatory compliance and fraud detection.
Commercial property insurer hiring a skilled claims examiner to handle complex, high-value losses. The company supports remote work and collaborative claims handling, with team size and culture not disclosed.
Conduct investigations and inspections to assess damage, estimate costs, and determine settlement amounts.
Analyze medical, financial, and job information to determine eligibility for benefits based on statutory criteria.
Settle claims in accordance with standards and negotiate with all parties involved to ensure smooth processing.
Desjardins Group is the largest cooperative financial group in North America, offering a full range of financial products and services. With over 52,000 employees and named one of Canada's top employers, they foster a people-first culture and are committed to equity, diversity, and inclusion.
Investigates and processes commercial claims, evaluating coverage and damages within assigned authority.
Communicates directly with insureds, claimants, agents, and internal customers to resolve claims.
Documents claim files, negotiates settlements, and identifies fraud or subrogation potential.
Liberty Mutual is a global insurance company offering commercial and personal insurance products and services. With a fast-growing and inclusive culture, the company values employee development, well-being, and diversity across its large national workforce.