Credit Card Fraud Investigator, Sr. jobs in Sioux Falls, SD

Credit Card Fraud Investigator, Sr. investigates suspected fraudulent use of credit cards issued by the organization. Interviews individuals involved and coordinates investigations with law enforcement personnel. Being a Credit Card Fraud Investigator, Sr. analyzes loss trends and makes recommendations to prevent further loss. Requires a bachelor's degree. Additionally, Credit Card Fraud Investigator, Sr. typically reports to a supervisor or manager. The Credit Card Fraud Investigator, Sr. contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Credit Card Fraud Investigator, Sr. typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

S
Healthcare Fraud Investigator
  • Sanford Health
  • Sioux Falls, SD FULL_TIME
  • Create Your Career With Us!

    Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

    Facility: Cherapa Place Building

    Location: Sioux Falls, SD

    Address: 300 N Cherapa Pl, Sioux Falls, SD 57103, USA

    Shift: 8 Hours - Day Shifts

    Job Schedule: Full time

    Weekly Hours: 40.00

    Salary Range: $29.00 - $46.50

    Department Details

    Well qualified candidates will have strong skills in:

    • Project Management
    • Critical Thinking
    • Auditing / Evaluation / Investigation

    The day to day work of a Healthcare Fraud Investigator is managing investigations and projects of varying scopes from start to end.

    Key accountabilities of Health Plan Compliance Department include:

    • FWA Policies and Procedures
    • FWA Training & Education
    • Reported Concerns
    • FWA Risk Assessment & Work Plans
    • Special Investigations Unit

    Job Summary

    Responsible for conducting audits and investigations of potentially fraudulent claim activity. Will plan, develop, and implement investigative processes and procedures. Conduct preliminary investigations, involving internal and external research, detailed data analyses, review of medical records, and interviews of members, providers, and other third parties. Analyzes information gathered by the investigation/audit and report findings, preparing written summaries and recommendations. Conducts investigative interviews of patients and providers as necessary.

    Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies. Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance. May represent company as a witness in judicial proceedings when appropriate.

    Performs special projects requiring expertise in fraud detection, data analytics, investigation, claim auditing and other areas related to Special Investigations. Completes reports of investigative findings and recommends investigative next steps. Identifies root causes of fraud, proposing internal and external corrective actions to address these root causes. Advises on investigative priorities, strategies, and techniques.

    Apply laws, regulations, plan policies and guidelines, contract provisions, coding rules, coverage rules, and industry standards to information gathered during the investigation. Share expertise and promoting investigative best practices among management and staff. Educate and collaborate with various business units to raise awareness of potential concerns.

    Must have excellent communication and interpersonal skills, along with strong analytical and problem-solving abilities. Ability to work on complex projects with general direction and minimal guidance.

    Qualifications

    Bachelor’s degree in health related field or equivalent education is required. Master’s degree is preferred.

    Minimum 3 years’ experience in health insurance investigation/audit.

    Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE). Or eligible for certification within 1 year.

    Benefits

    Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

    Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

    Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

    Req Number: R-0176718

    Job Function: Legal and Compliance

    Featured: No

  • 1 Month Ago

T
Fraud Analyst I
  • The Bancorp Bank, N.A.
  • Sioux Falls, SD FULL_TIME
  • Fraud Analyst I Job Location US-SD-Sioux Falls Type Full Time Overview Work through daily reporting to identify cardholder activity that violates the banks procedures specific to suspicious activity m...
  • 21 Days Ago

B
Fraud Analyst I
  • Bancorp Bank, The
  • Sioux Falls, SD FULL_TIME
  • Overview Work through daily reporting to identify cardholder activity that violates the banks procedures specific to suspicious activity monitoring. Flag accounts with suspicious behavior and alert th...
  • 22 Days Ago

B
Fraud Manager - BitGo Trust Company
  • BitGo
  • Sioux Falls, SD FULL_TIME
  • BitGo is the leader in digital asset financial services, providing institutional investors with liquidity, custody, and security solutions. In 2020, BitGo launched Prime Trading and Lending, as well a...
  • 28 Days Ago

S
Credit Analyst
  • Security Bank
  • Tyndall, SD FULL_TIME
  • Overview: Security Bank’s Credit Analyst position is for an individual wanting to gain knowledge and make a career in the banking world. The Credit Analyst will be responsible for analyzing credit inf...
  • 21 Days Ago

S
Credit Analyst
  • Security Bank
  • Tyndall, SD FULL_TIME
  • Overview: Security Bank’s Credit Analyst position is for an individual wanting to gain knowledge and make a career in the banking world. The Credit Analyst will be responsible for analyzing credit inf...
  • 22 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Credit Card Fraud Investigator, Sr. jobs found in Sioux Falls, SD area

D
Internal Revenue Agent (Fed State Local Gvmt Spec - Examiner) 12 MONTH ROSTER AMENDED
  • Department Of The Treasury
  • Sioux Falls, SD
  • Duties WHAT IS THE TAX EXEMPT & GOVERNMENT ENTITIES (TE/GE) DIVISION? A description of the business units can be found a...
  • 3/28/2024 12:00:00 AM

D
Internal Revenue Agent - 12 Month Roster
  • Department Of The Treasury
  • Sioux Falls, SD
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
  • 3/28/2024 12:00:00 AM

P
Capital Markets Analyst I
  • Pathward, N.A.
  • Sioux Falls, SD
  • We are a hybrid, remote-office company dedicated to growing our talent anywhere! We have onsite locations in: Sioux Fall...
  • 3/28/2024 12:00:00 AM

R
Customer Service & Sales Associate
  • Riverside Payments
  • Sioux Falls, SD
  • Job Description Job Description Who we are: What are you working for? Sure, most people work for money, but beyond that....
  • 3/28/2024 12:00:00 AM

B
Senior Business Lender
  • BLACK HILLS FEDERAL CREDIT UNION
  • Sioux Falls, SD
  • Job Details Job Location SF - W 10th St. MSC - Sioux Falls, SD Description Who We Are We have the fundamental belief tha...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Examiner) 12 MONTH ROSTER 'AMENDED'
  • Department Of The Treasury
  • Sioux Falls, SD
  • Duties WHAT IS THE SMALL BUSINESS/SELF EMPLOYED (SBSE) DIVISION? A description of the business units can be found at: ht...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Special Enforcement Program - Examiner) 12 MONTH ROSTER (Amended)
  • Department Of The Treasury
  • Sioux Falls, SD
  • Duties WHAT IS THE SMALL BUSINESS/SELF EMPLOYED (SBSE) DIVISION? A description of the business units can be found at: ht...
  • 3/27/2024 12:00:00 AM

D
Internal Revenue Agent (Examiner) 12 MONTH ROSTER AMENDED
  • Department Of The Treasury
  • Sioux Falls, SD
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL (LB&I)DIVISION? A description of the business units can be found at:...
  • 3/26/2024 12:00:00 AM

Sioux Falls (/ˌsuː ˈfɔːlz/) (Lakota: Íŋyaŋ Okábleča Otȟúŋwahe; "Stone Shatter City") is the most populous city in the U.S. state of South Dakota and the 143rd-most populous city in the United States. It is the county seat of Minnehaha County and also extends into Lincoln County to the south, proximate with the Minnesota state line. It is the 47th-fastest-growing city in the United States and the fastest-growing metro area in South Dakota, with a population increase of 22% between 2000 and 2010. As of 2019, Sioux Falls had an estimated population of 187,200. The metropolitan population of 259,0...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Credit Card Fraud Investigator, Sr. jobs
$43,961 to $60,032
Sioux Falls, South Dakota area prices
were up 0.8% from a year ago

Credit Card Fraud Investigator, Sr. in Middlesex, NJ
Credit card frauds form a part of cyber security investigations and thus the credit card fraud investigator must possess sharp technical skills for handling software, ethical hacking ways, accessing databases etc.
December 29, 2019
Credit Card Fraud Investigator, Sr. in Los Angeles, CA
They have to be familiar with certain concepts and practices that an investigator must know and perform the tasks accordingly in regulation with the law, whether it is federal or state.
December 09, 2019
Credit Card Fraud Investigator, Sr. in Springfield, OR
In order to restrict those incidences and provide secured credit card transactions to clients, financial organizations appoint credit card investigators to investigate such scams and book the offenders.
January 07, 2020