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Overnight Fraud Claims Jobs (NOW HIRING)

HHAeXchange

Sr. Program Integrity Analyst

$118K - $119K/yr

... Fraud Pattern Identification * Analyze Medicaid claims, visit, and EVV datasets to identify ... Travel up to 10%, including overnight travel Required Education, Experience, Certifications and ...

New

HHAeXchange

Sr. Program Integrity Analyst

Charleston, WV · Remote

$118K - $119K/yr

... Fraud Pattern Identification * Analyze Medicaid claims, visit, and EVV datasets to identify ... Travel up to 10%, including overnight travel Required Education, Experience, Certifications and ...

New

Peraton

Nurse Reviewer - Medicaid

$66K - $106K/yr

Overnight travel may be required. * Telework available from contiguous United States ... claims for technical requirements, performing medical review, and/or developing fraud cases

Peraton

Nurse Reviewer - Medicaid

Herndon, VA · On-site

$66K - $106K/yr

Overnight travel may be required. * Telework available from contiguous United States ... claims for technical requirements, performing medical review, and/or developing fraud cases

Peraton

Nurse Reviewer - Medicaid

Reston, VA · On-site

$66K - $106K/yr

Overnight travel may be required. * Telework available from contiguous United States ... claims for technical requirements, performing medical review, and/or developing fraud cases

HealthOne Alliance

Payment Integrity Analyst

Dalton, GA · On-site

... healthcare claims, payments, and billing to find errors, fraud, waste, or abuse, ensuring ... Must be able to drive a vehicle and daytime/overnight travel as required. BENEFITS 401K (4% Match ...

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Overnight Fraud Claims information

What unique challenges do overnight fraud claims specialists face, and how can they manage them?

Overnight fraud claims specialists often handle high-pressure situations with minimal direct supervision, as they work outside of standard business hours. This role requires quick decision-making and strong attention to detail, especially since fraudulent activity can peak during off-hours. Specialists must be comfortable working independently, but also know when and how to escalate complex cases to daytime teams. Developing strong communication skills and staying up-to-date on the latest fraud trends are key to managing these challenges successfully.

What is an overnight fraud claims specialist?

Overnight Fraud Claims specialists are professionals who handle reports of fraudulent transactions and account activity during overnight hours. They are responsible for reviewing, investigating, and resolving claims of fraud made by customers, often working for banks or financial institutions. These specialists play a crucial role in protecting customer accounts and minimizing financial losses by quickly identifying unauthorized activity and taking appropriate action. Their work ensures that fraud is addressed promptly, even outside of regular business hours, maintaining the security and trust of financial services.

What is the difference between Overnight Fraud Claims vs Fraud Claims Adjuster?

AspectOvernight Fraud ClaimsFraud Claims Adjuster
CredentialsInsurance licenses, claims handling certificationsInsurance licenses, claims handling certifications
Work EnvironmentRemote or night shift, insurance companiesOffice or remote, insurance companies or third-party firms
Industry UsageHandling overnight fraud claims specificallyHandling various types of insurance fraud claims
Search IntentCompare overnight fraud claims roles with fraud claims adjustersCompare fraud claims adjuster roles with overnight fraud claims

Overnight Fraud Claims focus on managing fraud cases during night shifts, often requiring specialized knowledge of fraud detection and insurance policies. Fraud Claims Adjusters handle a broader range of insurance fraud cases during regular hours. While both roles require similar credentials, their work hours and scope differ, with Overnight Fraud Claims roles emphasizing night shift operations and specific fraud detection skills.

What skills and qualifications are needed to thrive as an overnight fraud claims specialist?

To thrive as an Overnight Fraud Claims Specialist, you need strong analytical abilities, attention to detail, and a background in finance or banking, often supported by experience or education in a relevant field. Familiarity with fraud detection software, case management systems, and banking platforms is typically required, along with knowledge of regulations such as Reg E. Effective communication, critical thinking, and the ability to remain calm under pressure are standout soft skills for this position. These skills and qualities are vital for quickly identifying and resolving fraudulent activities, minimizing financial losses, and maintaining customer trust during overnight hours.
What cities are hiring for Overnight Fraud Claims jobs? Cities with the most Overnight Fraud Claims job openings:
What are the most commonly searched types of Fraud Claims jobs? The most popular types of Fraud Claims jobs are:
What states have the most Overnight Fraud Claims jobs? States with the most job openings for Overnight Fraud Claims jobs include:
Overnight Fraud Claims jobs near you

Special Investigations Unit (SIU) - Field Investigator

Ethos Risk Services

San Francisco, CA

Part-time

Re-posted 2 days ago

Job description

ABOUT US:

Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for our clients.

JOB SUMMARY:

Our dynamic Ethos team is seeking a Special Unit Investigations (SIU) Field Investigator to conduct field investigations, gather and analyze evidence, and produce detailed reports that support claims decisions. You'll work both independently and collaboratively, often traveling to accident scenes, interviewing witnesses, and uploading documentation into our claims system.

KEY RESPONSIBILITIES:

  • Scene Investigations: Conduct thorough on-site investigations of accidents and property losses.
  • Interviews & Statements: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved.
  • Online Research: Gather case information through digital sources and background checks.
  • Report Writing: Draft thorough, detailed investigative reports summarizing findings and observations.
  • Case Documentation: Conduct in-person interviews and obtain accurate, detailed statements from all parties involved, and retrieve relevant documents to support investigative findings.
  • Case Management: Track case progress, time, and expenses accurately within Ethos systems.
  • Fraud Detection: Recognize compensability issues, misrepresentation, and other red flags in claims.
  • Client Communication: Maintain professional contact with clients and claim handlers throughout the investigation process.


QUALIFICATIONS:

Education: Associate's or Bachelor's degree in Criminal Justice or a related field preferred.

Experience:

  • Minimum of 2 years of SIU experience with an investigative firm or insurance carrier, working across various lines of business such as liability, auto, and property.
  • Former military or law enforcement background preferred.

Licenses/Certifications:

  • Active Private Investigator license or willingness to obtain one (where required by state).
  • Active driver's license and valid auto insurance.

Other Requirements:

  • A well-maintained and reliable vehicle for exclusive use.
  • SIU equipment, including a recorder and a high-quality digital camera.
  • A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks.


WORKING CONDITIONS:

  • While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be required.
  • Occasional weekend work may be required to align with case demands and or/client requests.


Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.


A background check will be conducted, in accordance to the local state law and regulations.

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