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Position Details
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, Tampa, FL . Relocation assistance is not available for this position.
The Fraud Prevention Investigator will be on the Priority Investigations & Threats Team, within the Bank Fraud Prevention organization. This role reports directly to the Director, Priority Investigations & Threats Team. The team will investigate fraud events, initially to help mitigate the attack in parallel with gathering evidence to identify threat actors, continuing to further disrupt through external and law enforcement (LE) engagement.
What you’ll do:
Conducts and manages complex fraud investigations, impacting bank and investment products.
Conduct investigative analysis using a combination of internal tools, systems, data, and engagements of internal stakeholders and external intelligence sources (e.g. suppliers, peer financial institutions, information-sharing groups).
Prepares cases for presentation to appropriate law enforcement agencies for prosecution.
Working knowledge of the Bank Secrecy Act, USA Patriot Act, applicable laws and regulations, company policies, and investigative best practices.
Close coordination with Fraud Intelligence to embrace new cases and share newly gleaned intelligence, stemming from investigations.
Coordination with external partners, including the National Cyber Forensic Alliance (NCFTA), peer financial institutions (FI) and law enforcement personnel.
Engagement with other corporate entities for case specific coordination and new partnership development.
What you have:
Bachelor’s Degree: OR 4 years of related financial services or federal, state, local, or military law enforcement investigations experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.
4 years of experience in financial services or financial crimes experience to include 2 years of federal/local/state/military law enforcement investigations.
Advanced knowledge of the Bank Secrecy Act, USA Patriot Act, and other applicable laws and regulations.
Advanced knowledge of Microsoft Office.
Strong oral and written communication skills.
Demonstrated experience analyzing and interpreting data to identify trends and patterns.
What sets you apart:
Advanced knowledge of the financial services industry including bank fraud typologies and TTPs (e.g., ATO, social engineering, phishing, ID theft, etc.) and tools used in the detection and analysis of cyber-enabled fraud.
Strong familiarity with banking products and services including, checking/savings accounts, credit cards, mortgages, auto loans, etc. and how they’re targeted by threat actors.
Previous experience with information-sharing groups such as the NCFTA, FS-ISAC, obtain, share and analyze intelligence for the purpose of fraud risk mitigation.
Advanced licenses and certifications such as CFE, CAMS, CISSP are preferred, but not required.
Skilled with Excel, Word, PowerPoint and Visio.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
What we offer:
Compensation : The salary range for this position is: $77,120 - $138,810.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Position Details
Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for USAA. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice.
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, Tampa, FL . Relocation assistance is not available for this position.
The Fraud Prevention Investigator will be on the Priority Investigations & Threats Team, within the Bank Fraud Prevention organization. This role reports directly to the Director, Priority Investigations & Threats Team. The team will investigate fraud events, initially to help mitigate the attack in parallel with gathering evidence to identify threat actors, continuing to further disrupt through external and law enforcement (LE) engagement.
What You'll Do
• Conducts and manages complex fraud investigations, impacting bank and investment products.
• Conduct investigative analysis using a combination of internal tools, systems, data, and engagements of internal stakeholders and external intelligence sources (e.g. suppliers, peer financial institutions, information-sharing groups).
• Prepares cases for presentation to appropriate law enforcement agencies for prosecution.
• Working knowledge of the Bank Secrecy Act, USA Patriot Act, applicable laws and regulations, company policies, and investigative best practices.
• Close coordination with Fraud Intelligence to embrace new cases and share newly gleaned intelligence, stemming from investigations.
• Coordination with external partners, including the National Cyber Forensic Alliance (NCFTA), peer financial institutions (FI) and law enforcement personnel.
• Engagement with other corporate entities for case specific coordination and new partnership development.
What You Have
• Bachelor's Degree: OR 4 years of related financial services or federal, state, local, or military law enforcement investigations experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.
• 4 years of experience in financial services or financial crimes experience to include 2 years of federal/local/state/military law enforcement investigations.
• Advanced knowledge of the Bank Secrecy Act, USA Patriot Act, and other applicable laws and regulations.
• Advanced knowledge of Microsoft Office.
• Strong oral and written communication skills.
• Demonstrated experience analyzing and interpreting data to identify trends and patterns.
What Sets You Apart
• Advanced knowledge of the financial services industry including bank fraud typologies and TTPs (e.g., ATO, social engineering, phishing, ID theft, etc.) and tools used in the detection and analysis of cyber-enabled fraud.
• Strong familiarity with banking products and services including, checking/savings accounts, credit cards, mortgages, auto loans, etc. and how they're targeted by threat actors.
• Previous experience with information-sharing groups such as the NCFTA, FS-ISAC, obtain, share and analyze intelligence for the purpose of fraud risk mitigation.
• Advanced licenses and certifications such as CFE, CAMS, CISSP are preferred, but not required.
• Skilled with Excel, Word, PowerPoint and Visio.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
What We Offer
Compensation : The salary range for this position is: $77,120 - $138,810.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
If you are an existing USAA employee, please use the internal career site in OneSource to apply.
Please do not type your first and last name in all caps.
Find your purpose. Join our mission.
USAA is unlike any other financial services organization. The mission of the association is to facilitate the financial security of its members, associates and their families through provision of a full range of highly competitive financial products and services; in so doing, USAA seeks to be the provider of choice for the military community. We do this by upholding the highest standards and ensuring that our corporate business activities and individual employee conduct reflect good judgment and common sense, and are consistent with our core values of service, loyalty, honesty and integrity.
USAA attributes its long-standing success to its most valuable resource: our 35,000 employees. They are the heart and soul of our member-service culture. When you join us, you'll become part of a thriving community committed to going above for those who have gone beyond: the men and women of the U.S. military, their associates and their families. In order to play a role on our team, you don't have to be connected to the military yourself - you just need to share our passion for serving our more than 13 million members.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
California applicants, please review our HR CCPA - Notice at Collection (https://statmcstg.usaa.com/mcontent/static_assets/Media/enterprise_hr_cpra_notice_at_collection.pdf) here.
USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.
If you have questions about this posting, please contact support@lensa.com
Position Details
Careers With Purpose
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: Marsh Security Hlth Plan
Location: Marshfield, WI
Address: 1515 N St Joseph Ave, Marshfield, WI 54449, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $29.00 - $46.50
Department Details
• Bachelor’s degree in health related field or equivalent education is required.
• Minimum 3 years’ experience in health insurance investigation/audit.
• Master's Degree preferred
• Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred
• Nursing or other clinical experience highly preferred
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.
Minimum 3 years’ experience in health insurance investigation/audit.
Master's Degree preferred
Accredited Health Care Fraud Investigator (AHFI) certification or Certified Fraud Examiner (CFE) preferred
Nursing or other clinical experience highly preferred
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-0233662
Job Function: Legal and Compliance
Featured: No
Position Details
Come join a growing financial technology company that’s leading the marketplace in both the marketing and servicing of credit cards! Continental Finance Company specializes in credit card options for those consumers with less than perfect credit. We are seeking a Fraud Investigator to support our Risk team.
The Fraud Investigator is part of the fraud team and is committed to minimizing Continental Finance Company’s (CFC) financial losses from fraud attacks. The Fraud Team is responsible for building and implementing strategies that reduce risk for CFC and preserve a healthy financial ecosystem, while creating positive experiences for our cardholders.
As a Fraud Investigator, you will be directly responsible for decreasing losses from fraud attempts including but not limited to account takeovers, fraud applications, identifying fraudulent payments.
Essential Functions:
• Monitor accounts and transactions to identify and predict risky behavior that could result in losses.
• Research and monitor suspicious activity on accounts, payments, demographic changes, online and mobile banking accounts, or electronic payment functions including tokenized transactions (Apple Pay, Google Pay).
• Work together with a team and individually to develop, configure and make a business decision to stop high risk fraud attacks to minimize banks’ exposure to fraud losses.
• Balance loss decisions with the impact on operational teams and the customer experience.
• Produce timely diagnostics to identify system, strategy and operational issues
• Independently collaborate with multi-functional teams (IE product, customer experience, risk) to ensure project is executed with appropriate controls.
• Identify risk exposures/gaps and solution process improvement.
• Maintain strong relationships with internal partners such as marketing, enterprise risk management, digital, product, customer service, and compliance.
• Conduct call outs to cardholders to identify any suspicious activity.
• Other duties as assigned.
The ideal candidate will have the following:
• High School diploma required; bachelor’s degree preferred.
• Minimum 2 years’ experience in payment processing or fraud domain.
• Evaluating and identifying fraud trends and engaging with internal partners to assist with investigating the root cause of losses.
• Ability to perform problem solving in a complex environment by using business understanding and good judgment.
• Exceptional written and verbal communication skills for interactions at all levels across the organization.
• Must be resourceful, creative, innovative, results driven, and adaptable.
Why Continental Finance?
Continental Finance Company (the “CFC”) is one of America’s leading marketers and servicers of credit cards for consumers with less-than-perfect credit. Since our founding in 2005, we have prided ourselves on corporate responsibility to customers in terms of a strong customer support program and fair treatment. With our success, we have also grown into an innovative financial tech company! With a state-of-the-art consumer marketing and servicing platform, we provide a variety of services to consumers when other financial institutions will not accommodate them. With more than 2.6 million credit cards managed and serviced since our founding, we pride ourselves on putting the customer first. We are not a chartered banking financial institution, nor are we a debt originator or a credit card issuer.
CFC is an equal opportunity employer that is committed to inclusion and diversity. Our company provides equal employment opportunity (EEO) regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or veteran status.
CFC is seeking bright, energetic individuals that will help us grow and develop together! We uphold a promise to treat our employees with the same care and concern as we do our customers. We offer all employees competitive compensation and benefits in an exciting, fast-paced business casual environment. Join our growing team and apply online today!
CFC offers a hybrid work schedule which includes three (3) core days in the office (Tuesday, Wednesday, and Thursday) and two (2) remote workdays (Monday and Friday)
Position Details
About Binance.US:
Binance.US is America's home to buy, trade, and earn digital assets. As a licensed and regulated U.S. crypto platform, Binance.US offers some of the lowest fees in the industry and provides secure and reliable access to more than 160 of the world’s most popular cryptocurrencies. We’re on a mission to empower people to do more with their money. The new economy has arrived and we’re committed to helping everyone access the world of blockchain and crypto. To learn more about Binance.US, visit https://www.binance.us/. All roles supporting Binance.US are employed via BAM Management US Holdings Inc. or BAM Management Canada Holdings Inc.
About This Role:
The Risk & Fraud Investigator is part of the Risk team and reports to our Senior Manager, Fraud & Risk. As a Risk & Fraud Investigator, you will utilize your inherent analytical and problem-solving abilities to assess cases in order to identify patterns or anomalies within intricate transactions, workflows, and risk management procedures. You will collaborate on a regular basis with other partner teams, such as Risk Operations, Customer Success, Compliance, and Data, to encourage innovation and have an impact on our overall risk programs and processes. In addition, the Risk & Fraud Investigator will collaborate with our Risk Ops BPO teams to ensure the maintenance of Quality Assurance programs and training.
The ideal candidate will possess exceptional analytical and communication abilities. They will conduct time-sensitive and thorough investigations with an emphasis on fraudulent or high-risk activities, including Account Takeover, Identity Theft, Scam, and other fraud taxonomies. The successful candidate will be proficient in the development of training, workflows, and the provision of feedback to risk operational teams and business partners. They will meticulously maintain all investigation-related records and supporting documentation. Additionally, the candidate must be able to solve ambiguous problems and possess a strong sense of self-motivation.
Core Responsibilities:
• Investigate complex fraud situations including account takeover, elder and vulnerable abuse, and identity theft
• Secure accounts by placing blocks to prevent financial loss
• Identify fraud trends and communicate them to management
• Ability to conceptualize, develop, and implement process improvements
• Flexibility to adapt and able to manage multiple assignments while working independently
• Assist in developing technical specifications for tool enhancements, build-out, and fine-tuning
• Work closely with partner teams, such as Risk Operations, Customer Success, Compliance, and Data, to encourage innovation and have an impact on our overall risk programs, processes, and workflows
• Understanding of blockchain analysis
• Document and provide monitoring sessions to RIsk Ops and Training/QA teams
Preferred Skills/Experience:
• Certified Fraud Examiner (CFE), Certified Anti-Money Laundering Specialist (CAMS)
• Basic SQL
• Blockchain tracing
• Visualization knowledge in Datawind, Tableau
• Efficient in Google Suite Products
Salary:
The starting pay range for this role is USD $85,000 for all U.S.remote locations. The actual base pay will vary, and is dependent upon many factors, such as transferable skill sets, work experience, business needs, and market demands. The base pay range is subject to change.
BAM Management US Holdings Inc. and BAM Management Canada Holdings Inc. are Equal Opportunity Employers. Our mission is to give Americans access to a broad array of digital assets, and we thrive because of the diverse and inclusive team that we are building. We do not discriminate against qualified employees or applicants because of race, color, religion, gender identity, sex, sexual preference, sexual identity, pregnancy, national origin, ancestry, citizenship, age, marital status, physical disability, mental disability, medical condition, military status, or any other characteristic protected by local law or ordinance.
We comply with Federal Transparency in Coverage regulations by providing a link to machine readable files related to the health plans offered to our employees. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data including negotiated service rates, and out-of-network allowed amounts between health plans and healthcare providers.
Position Details
We are looking for an RCA-Fraud Specialist in Cincinnati OH for our client who is a leading global financial services firm providing a wide range of investment banking, securities, investment management and wealth management services.
Job title: Fraud & Compliance - RCA Specialist
Location: Cincinnati OH
Duration: 6 months
Pay rate: $26.43/hour
Position Description:
Responsibilities:
External Fraud Investigators may concentrate on one specific or many different fraud typologies such as external fraud, elder and vulnerable adult financial exploitation, technology related fraud, organized fraud rings and anti-money laundering depending on business needs within Fraud Investigations. External Fraud Investigators perform duties such as investigating multiple fraud typologies in accordance with policies and procedures, performing thorough account transaction analysis for the purpose of identifying suspicious or fraudulent activity, and filing Suspicious Activity Reports (SARs). An investigator may review consumer and commercial DDAs, loans, lines of credit, debit and credit cards, technology products and investment products.
-Maintain thorough and accurate case notes setting forth all required actions in chronological order through utilization of a case management system.
-Conduct and documenting interviews with witnesses, victims and subjects as appropriate.
-Report investigative findings to the appropriate designee within Fraud Investigations with recommendation for SAR or no SAR Determination.
-Prepare complete and accurate SARs for filing.
-Ability to correctly identify when matters are appropriate to escalate to management and/or to law enforcement.
-Ensure case accurate case completion for all case resolutions prior to submission to appropriate designee within Fraud Investigations for case closure approval.
-Participation and compliance with internal continuing education and training. Training topics may include: Compliance with the U.S. Bank Code of Ethics and all Anti-Money Laundering, Bank Secrecy Act, information security and suspicious activity reporting requirements, policies and procedures. Participation in any required corporate and business line training in these areas. Understanding and adherences to internal suspicious activity referral requirements and processes as required for this position.
Preferred Qualifications
- Bachelor's degree, or equivalent work experience
- 2-3 years of experience in an applicable risk management environment
- Certified Fraud Examiner (CFE) or other professional fraud certification
- Experience interviewing suspects and/or victims
• **Please answer the screening questions
SCREENING QUESTIONS
If the candidate notates SAR filing and/or investigations experience on their resume, please ask the following screening questions:
1. What system(s) did you use to file a Suspicious Activity Report (SAR)?
2. What are the Suspicious Activity Report (SAR) filing thresholds?
3. Are you familiar with the basic requirements of an accurate and complete Suspicious Activity Report (SAR)? If so, can you provide the sections of the SAR and their requirements?
4. How do you conduct an investigation?
5. What are examples of fraud typologies?
If the candidate does not have SAR filing and/or investigations experience on their resume, please ask the following screening questions:
1. What is your writing experience?
BENEFITS DISCLOSURE
“Russell Tobin offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.”
Apply Now
Position Details
Who We Are At Corebridge Financial, we believe action is everything. That’s why every day we partner with financial professionals and institutions to make it possible for more people to take action in their financial lives, for today and tomorrow. We align to a set of Values that are the core pillars that define our culture and help bring our brand purpose to life: We are stronger as one: We collaborate across the enterprise, scale what works and act decisively for our customers and partners. We deliver on commitments: We are accountable, empower each other and go above and beyond for our stakeholders. We learn, improve and innovate: We get better each day by challenging the status quo and equipping ourselves for the future. We are inclusive: We embrace different perspectives, enabling our colleagues to make an impact and bring their whole selves to work. Fraud Examiner Who We Are At Corebridge Financial, we believe action is everything. That’s why every day we partner with financial professionals and institutions to make it possible for more people to take action in their financial lives, for today and tomorrow. We align to a set of Values that are the core pillars that define our culture and help bring our brand purpose to life: We are stronger as one: We collaborate across the enterprise, scale what works and act decisively for our customers and partners We deliver on commitments: We are accountable, empower each other and go above and beyond for our stakeholders We learn, improve and innovate: We get better each day by challenging the status quo and equipping ourselves for the future We are inclusive: We embrace different perspectives, enabling our colleagues to make an impact and bring their whole selves to work About The Role The Fraud Specialist serves as a senior-level investigator within the Fraud Investigations team, responsible for conducting mid- to high-complexity fraud investigations across all lines of business. This role goes beyond standard fraud analysis by providing subject matter expertise, supporting fraud mitigation strategies, and mentoring junior analysts. A Certified Fraud Examiner (CFE), the Fraud Specialist leverages investigative acumen and advanced fraud detection tools to identify schemes, resolve complex cases, and reduce organizational risk. Responsibilities Lead complex fraud investigations (Level 2) involving digital account takeover, identity theft, synthetic fraud, internal fraud, and high-dollar losses. Utilize fraud detection systems, internal case management tools, and third-party solutions (e.g., Giact, Pindrop) to identify patterns and investigate referrals. Ensure accurate, complete, and timely documentation of investigative findings. Collaborate with the SIU team when cases meet escalation thresholds or regulatory referral criteria. Support the QA process by serving as a peer reviewer or calibration partner for Level 1 and Level 2 cases. Serve as a process SME to improve training materials, QA standards, and fraud typology guides in partnership with the Training and QA teams. Work directly with call centers, customer service, and IT teams to understand fraud entry points and recommend control enhancements. Conduct fraud trend analysis and share findings to support broader fraud prevention strategies. Support the development and onboarding of new fraud analysts through mentoring and informal leadership. Maintain compliance with internal policies, industry best practices, and regulatory requirements. Please note this is not an exhaustive list of all responsibilities of the position, and the requirements of the job may change in line with business needs. Skills and Qualifications Bachelor’s degree in Criminal Justice, Business, or a related field. Active Certified Fraud Examiner (CFE) credential required. 5+ years of fraud investigation experience, including experience handling complex investigations across multiple product lines. Advanced knowledge of fraud schemes and fraud detection tools (e.g., Giact, Pindrop, SecureLogix, FraudShare). Strong written and verbal communication skills, including the ability to document findings clearly and concisely. Ability to mentor, influence, and support team members and cross-functional stakeholders. Experience with call center red flags, identity validation, and online account takeover investigations strongly preferred. Work Location This position is based in Corebridge Financial’s Houston office and is subject to our hybrid working policy, which gives colleagues the benefits of working both in an office and remotely. Why Corebridge? At Corebridge Financial, we prioritize the health, well-being, and work-life balance of our employees. Our comprehensive benefits and wellness program is designed to support employees both personally and professionally, ensuring that they have the resources and flexibility needed to thrive. Benefit Offerings Include: Health and Wellness: We offer a range of medical, dental and vision insurance plans, as well as mental health support and wellness initiatives to promote overall well-being Retirement Savings: We offer retirement benefits options, which vary by location. In the U.S., our competitive 401(k) Plan offers a generous dollar-for-dollar Company matching contribution of up to 6% of eligible pay and a Company contribution equal to 3% of eligible pay (subject to annual IRS limits and Plan terms). These Company contributions vest immediately. Employee Assistance Program: Confidential counseling services and resources are available to all employees Matching charitable donations: Corebridge matches donations to tax-exempt organizations 1:1, up to $5,000 Volunteer Time Off: Employees may use up to 16 volunteer hours annually to support activities that enhance and serve communities where employees live and work Paid Time Off: Eligible employees start off with at least 24 Paid Time Off (PTO) days so they can take time off for themselves and their families when they need it. Eligibility for and participation in employer-sponsored benefit plans and Company programs will be subject to applicable law, governing Plan document(s) and Company policy. We are an Equal Opportunity Employer Corebridge Financial, is committed to being an equal opportunity employer and we comply with all applicable federal, state, and local fair employment laws. All applicants will be considered for employment based on job-related qualifications and without regard to race, color, religion, sex, gender, gender identity or expression, sexual orientation, national origin, disability, neurodivergence, age, veteran status, or any other protected characteristic. The Company is also committed to compliance with all fair employment practices regarding citizenship and immigration status. At Corebridge Financial, we believe that diversity and inclusion are critical to building a creative workplace that leads to innovation, growth, and profitability. Through a wide variety of programs and initiatives, we invest in each employee, seeking to ensure that our colleagues are respected as individuals and valued for their unique perspectives. Corebridge Financial is committed to working with and providing reasonable accommodations to job applicants and employees, including any accommodations needed on the basis of physical or mental disabilities or sincerely held religious beliefs. If you believe you need a reasonable accommodation in order to search for a job opening or to complete any part of the application or hiring process, please send an email to TalentandInclusion@corebridgefinancial.com. Reasonable accommodations will be determined on a case-by-case basis, in accordance with applicable federal, state, and local law. We will consider for employment qualified applicants with criminal histories, consistent with applicable law. Why Corebridge? At Corebridge Financial, we prioritize the health, well-being, and work-life balance of our employees. Our comprehensive benefits and wellness program is designed to support employees both personally and professionally, ensuring that they have the resources and flexibility needed to thrive. Benefit Offerings Include: Health and Wellness: We offer a range of medical, dental and vision insurance plans, as well as mental health support and wellness initiatives to promote overall well-being. Retirement Savings: We offer retirement benefits options, which vary by location. In the U.S., our competitive 401(k) Plan offers a generous dollar-for-dollar Company matching contribution of up to 6% of eligible pay and a Company contribution equal to 3% of eligible pay (subject to annual IRS limits and Plan terms). These Company contributions vest immediately. Employee Assistance Program: Confidential counseling services and resources are available to all employees. Matching charitable donations: Corebridge matches donations to tax-exempt organizations 1:1, up to $5,000. Volunteer Time Off: Employees may use up to 16 volunteer hours annually to support activities that enhance and serve communities where employees live and work. Paid Time Off: Eligible employees start off with at least 24 Paid Time Off (PTO) days so they can take time off for themselves and their families when they need it. Eligibility for and participation in employer-sponsored benefit plans and Company programs will be subject to applicable law, governing Plan document(s) and Company policy. We are an Equal Opportunity Employer Corebridge Financial, is committed to being an equal opportunity employer and we comply with all applicable federal, state, and local fair employment laws. All applicants will be considered for employment based on job-related qualifications and without regard to race, color, religion, sex, gender, gender identity or expression, sexual orientation, national origin, disability, neurodivergence, age, veteran status, or any other protected characteristic. The Company is also committed to compliance with all fair employment practices regarding citizenship and immigration status. At Corebridge Financial, we believe that diversity and inclusion are critical to building a creative workplace that leads to innovation, growth, and profitability. Through a wide variety of programs and initiatives, we invest in each employee, seeking to ensure that our colleagues are respected as individuals and valued for their unique perspectives. Corebridge Financial is committed to working with and providing reasonable accommodations to job applicants and employees, including any accommodations needed on the basis of physical or mental disabilities or sincerely held religious beliefs. If you believe you need a reasonable accommodation in order to search for a job opening or to complete any part of the application or hiring process, please send an email to TalentandInclusion@corebridgefinancial.com. Reasonable accommodations will be determined on a case-by-case basis, in accordance with applicable federal, state, and local law. We will consider for employment qualified applicants with criminal histories, consistent with applicable law. To learn more please visit: www.corebridgefinancial.com Functional Area: CL - Claims Estimated Travel Percentage (%): No Travel Relocation Provided: No American General Life Insurance Company Thank you for your interest in careers at Corebridge Financial and for creating a user account on our Careers site. This page will allow you to check the status of your application(s), update your contact information, and receive important updates and materials related to your application(s). Corebridge Financial makes it possible for more people to take action in their financial lives. Corebridge is one of the largest providers of retirement solutions and insurance products in the United States. We proudly partner with financial professionals and institutions to help individuals plan, save for and achieve secure financial futures. For more information, visit www.corebridgefinancial.com. Thank you for your interest in joining our team.
Position Details
Healthcare Fraud Investigator I – Medicaid
Dallas, TX (hybrid) OR Remote U.S.
@Orchard LLC is retained by a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Our Client is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.
Serves as an entry level professional who develops baseline plans for ensuring the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and company policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes.
Essential Duties and Responsibilities:
• Conducts routine and impartial audits/investigations into customer claims, ensuring accurate and fair assessments of claims validity.
• Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed.
• Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements.
• Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process.
• Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims.
• Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards.
• Ensures that all audit and investigative documents and records are processed into the database in a timely and accurate manner.
• Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
• Supports management in regular audit and investigation proceedings, ensuring full compliance with all applicable regional and federal standards, regulations, and protocols.
Education and /or Skills and Experience Required:
• Minimum Bachelor's Degree
• Prior experience in federal or state healthcare programs or a related field that demonstrates expertise in reviewing, analyzing, and making appropriate decisions related to fraud, waste and abuse.
Preferred Skills/Experience:
• Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator
• Prior successful experience with CMS and OIG/FBI or similar agencies
• Medicaid investigation experience strongly preferred
• Claims Analysis or Policy Research experience preferred
If you match the requirements for this opportunity and believe you have the experience and talent to succeed in the role, we need to hear from you!
Established in 2010, @Orchard LLC, also known as, Talent Orchard has an exceptional reputation, providing staffing solutions to time-sensitive, talent scarcity issues to deliver better talent management ROI. Our specialty lies in the critical area of program talent acquisition and resource management, not in one narrow skillset, but across many areas of technical and functional delivery. To learn more about our other exciting opportunities, visit our Jobs Page at www.atOrchard.com.
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