2h ago
New
$69,800.00 - $125,900.00/yr

Lead Fraud Investigator

5 Locationslead
Other
1 views0 saves0 applied

Quick Summary

Requirements Summary

Bachelor’s Degree 7 years’ law enforcement experience (local, state, or federal) or 7 years fraud investigative experience.

Technical Tools
Other

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Description Summary
This position is responsible for planning and developing investigation tools and techniques to conduct detailed investigations of potentially fraudulent claim activity by members, employees and providers, both internally and externally initiated, and makes recommendations for prosecution, recovery, and litigation. Also, review operational controls, claim system controls and protocols, and recommends enhancements to reduce the potential for fraud.

Requirements

~1 min read
  • Bachelor’s Degree
  • 7 years’ law enforcement experience (local, state, or federal) or 7 years fraud investigative experience. Experience directing complex fraud investigations which result in criminal or civil prosecutions.
  • Experience planning and conducting interviews which develop significant information in furtherance of complex fraud, waste, and abuse investigations.
  • Familiarity with state and federal laws applicable to health care fraud.
  • Ability to develop effective liaison relations which facilitate case identification, investigation, and prosecution.
  • Ability to independently prepare reports of interview and other documentation accurately reflecting investigative activity and results.
  • Clear and concise verbal and written communication skills.
  • Self-motivated, results oriented with demonstrated leadership skills.

 

  • Accredited Health Care Fraud Investigator
  • Certified Professional Coder
  • Certified Fraud Examiner
  • Medicare Advantage Experience

 

 #LI-AS1

 #LI-Hybrid

 

 

 

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

 

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

$69,800.00 - $125,900.00

Exact compensation may vary based on skills, experience, and location.

Location & Eligibility

Where is the job
Not specified
Location terms not specified
Who can apply
Same as job location

About this job

Pay per year
$69,800–$125,900 a year
46% above the $67,000 median for Other jobs on Jobera (144,221 salaries).
Posted
Today
Employer
has 475 open jobs on Jobera.

Listing Details

Posted
November 13, 2026
First seen
November 13, 2026
Last seen
November 13, 2026

Posting Health

Days active
0
Repost count
0
Trust Level
67%
Scored at
November 13, 2026

Signal breakdown

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Lead Fraud Investigator$69,800.00 - $125,900.00