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Remote Fraud Manager Jobs in Arizona (NOW HIRING)

IQVIA

Care Manager

Phoenix, AZ · Remote

This is a remote position. Job Responsibilities: * Perform outbound calls to obtainappropriate ... fraud. All information and credentials submitted in your application must be truthful and complete.

Arizona Department of Administration

$71K - $115K/yr

REMOTE OPTIONS, PHOENIX Categories: Legal/Investigations/Adjustment/Compliance ATTORNEY GENERAL ... The Healthcare Fraud and Abuse Section receives an annual federal grant to cover 75% of ...

Arizona Department of Administration

$120K - $140K/yr

... Medicaid Fraud Control Unit of Office of Arizona Attorney General and other state/ federal law ... Remote work is a management option and not an employee entitlement or right. An agency may ...

Arizona Department of Administration

$43K - $63K/yr

REMOTE OPTIONS, PHOENIX, TUCSON Categories: Legal/Investigations/Adjustment/Compliance ATTORNEY ... Conduct interviews of witnesses and suspects in Arizona Consumer Fraud Act and environmental ...

IQVIA

Medical Biller/Claims Processing

Flagstaff, AZ · Remote

$23/hr

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to ... This role will be a contract role with IQVIA managed by an external agency, with the opportunity to ...

Oscar Health

Credentialing Specialist

Tempe, AZ · Remote

$19/hr

You will report into the Manager, Provider Credentialing. Work Location: This is a remote position ... Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an ...

Oscar Health

Member & Provider Care Specialist

Tempe, AZ · Remote

$22/hr

You will report into Member Escalations Operations Manager. Work Location: This is a remote role ... Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an ...

The Hartford

Property Claims Adjuster

Scottsdale, AZ · On-site +1

... manage subrogation, salvage and other recovery opportunities. * Identify fraud indicators and ... This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open ... Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an ...

Phoenix Staff

Senior Data & AI Engineer

Phoenix, AZ · On-site +1

$50 - $60/hr

Phoenix, AZ (hybrid remote) Type: 6-month contract to hire Pay: $50-60/hr We're looking for a ... utilization forecasting, fraud detection, quality measurement, and care gap analysis. · ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

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Remote Fraud Manager information

What does a Remote Fraud Manager do?

A Remote Fraud Manager is responsible for overseeing and implementing strategies to detect, prevent, and respond to fraudulent activities within a company, all while working remotely. They analyze transaction data, monitor suspicious activities, and lead a team of fraud analysts to mitigate risks. Additionally, they develop policies, train staff on identifying fraud, and collaborate with law enforcement or financial institutions when necessary. This role requires strong analytical skills, attention to detail, and up-to-date knowledge of fraud trends and prevention technologies.

What is the difference between Remote Fraud Manager vs Remote Fraud Analyst?

AspectRemote Fraud ManagerRemote Fraud Analyst
Required CredentialsTypically requires a bachelor’s degree in finance, criminal justice, or related field; certifications like CFE or CFCS are commonSimilar credentials; often holds a bachelor’s degree and may pursue certifications like CFE
Work EnvironmentLeads fraud prevention teams, manages strategies, and collaborates with other departments remotelyPerforms data analysis, investigates suspicious activity, and reports findings remotely
Employer & Industry UsageUsed by financial institutions, e-commerce, and insurance companies to oversee fraud preventionEmployed in similar industries to analyze fraud patterns and support fraud prevention efforts

The main difference is that a Remote Fraud Manager oversees fraud prevention strategies and manages teams, while a Remote Fraud Analyst focuses on investigating and analyzing suspicious activities. Both roles require similar credentials and are vital in fraud prevention, but the manager has a leadership and strategic role, whereas the analyst is more hands-on with data analysis.

What are the key skills and qualifications needed to thrive as a Remote Fraud Manager, and why are they important?

To thrive as a Remote Fraud Manager, you need strong analytical skills, expertise in fraud detection, and a background in finance, risk management, or a related field, often supported by a bachelor's degree. Familiarity with fraud management software, data analytics tools, and knowledge of industry regulations and certifications such as CFE (Certified Fraud Examiner) are highly valued. Excellent communication, problem-solving abilities, and attention to detail are crucial soft skills for collaborating with teams and making sound judgment calls remotely. These skills and qualities are vital to effectively identifying and mitigating fraud risks, ensuring organizational security, and maintaining trust with customers and stakeholders.

How does a Remote Fraud Manager typically collaborate with cross-functional teams to prevent and address fraudulent activities?

As a Remote Fraud Manager, you'll frequently work with teams such as risk management, compliance, IT, and customer service to monitor, investigate, and resolve fraud cases. Collaboration often occurs through virtual meetings, shared digital platforms, and regular reporting to ensure everyone is aligned on protocols and emerging threats. Building strong communication channels is essential to quickly address incidents and implement new fraud prevention strategies. You'll also help train team members on best practices and coordinate multi-department responses to complex fraud schemes.
What are popular job titles related to Remote Fraud Manager jobs in Arizona? For Remote Fraud Manager jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Remote Fraud Manager jobs in Arizona look for? The top searched job categories for Remote Fraud Manager jobs in Arizona are:
What cities in Arizona are hiring for Remote Fraud Manager jobs? Cities in Arizona with the most Remote Fraud Manager job openings:
Remote Fraud Manager jobs near you
Care Manager

Care Manager

IQVIA

Phoenix, AZ • Remote

Full-time

Posted yesterday

IQVIA rating

8.1

Company rating: 8.1 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

53rd of 207 rated it services

Job description

**This is posted in anticipation of a future role**

Position Summary:

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status.

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Care Manager

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma gettheir medicinestothe people who need them. We help customers gain insight and access to their markets andultimately demonstratetheirproduct'svalue to payers,physiciansand patients. A significant part of our business is acting as thebiopharma'ssales forcetophysicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.

Position Summary:

Responsibilities will vary by program and its lifecycle. Care Manager's maybe responsible forcontacting insurance companies to obtain correct eligibility information, perform benefit investigations, copayassistanceand check prior authorization and/or appeal status. Care Managers may alsobe responsible fordirectly contacting patients and/or providers to evaluate eligibility forassistanceprograms and/or variedadherencesupport. This is aremoteposition.

Job Responsibilities:

  • Perform outbound calls to obtainappropriate informationanddocumentaccurately.

  • Responsible for answering in-bound calls andassistingcustomers withpharmacy relatedservices.

  • Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.

  • Contact insurance companies for benefit investigation and coverage eligibility.

  • Provide prior authorizations and appeals support.

  • Assistpatients with the enrollment process for manufacturer and non-profitorganizationcopayassistanceprograms.

  • Update job knowledge byparticipatingin educational opportunities and training activities. Work efficiently both individually and within a team toaccomplishrequired tasks.

  • Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's.

  • Report ADE's according to program policy and guidelinesAdhereto all HIPAA guidelines Mayassistwith onboarding new employees.

Schedule:

  • Must be available for an8 hourshift between 8am-8pm EST

RequiredQualifications:

  • High School Diploma or equivalent

  • Minimum oneyearexperience in medical billing, reimbursement, insurance verification, or similar related medical office experience.

  • Previousdata entry experience (minimum three months) and ability to type 30wpm+.

  • Able todemonstratehigh attention to detail in work.

  • Mustbe computer savvy,to includenavigating multiple computer tabs,monitors,and applications.

  • Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook,etc.) and soft phone systems (WebEx, Mitel,Shoretel, etc.).

  • Exceptional communication skills, both written and verbal.

  • Able to work in a virtual team environment by being available and responsive during working hours.

  • Excellent follow through This is a remote position.

  • Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines.

  • Workspace must include internet plug-in accessibility. Wi-fi connectivity is notpermitted.

  • Mustresidein country wherethe jobis posted.

Preferred Qualifications:

  • Some College.

  • Bilingual Spanish - English

  • Previousexperience in Patient Support Services (Hub).

  • PreviousCustomer Service experience in the healthcare field.

#LI-CES

#LI-DNP

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be 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, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $22.00 - $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.

What IQVIA employees say

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Hours and flexibility

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About IQVIA

Sourced by ZipRecruiter

At IQVIA, we are passionate about helping customers and partners improve results and patient outcomes. Everything we do contributes to this vision for creating a healthier world. In today’s healthcare environment, it’s not only about how much data, information, and technology you have at your fingertips – it’s what you do with it. IQVIA is focused on making intelligent connections for customers across the entire healthcare ecosystem to help you drive healthcare forward. Whether that means partnering with novel technology companies to boost patient engagement, leveraging AI & machine learning to accelerate results, or using decentralized trials to reach the right patients wherever they are – we are always looking for smarter ways to move you forward.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Durham, NC, US

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