Fraud Consultant - Ltc Fraud, Waste & Abuse

Manulife

USA, Massachusetts
Base: $73,350.00 usd - $122,250.00 usd; bonus/equi...
Fully remote
Ltc claims review
Pattern recognition
Investigative strategies
Review LTC claims to identify fraud, waste, and abuse indicators using pattern recognition, documentation validation, and behavioral red flags

Job Summary

  • Review LTC claims to identify fraud, waste, and abuse indicators using pattern recognition, documentation validation, and behavioral red flags.
  • Conduct end-to-end investigations by gathering proof of payment/financial records, reviewing medical/clinical information, researching claimants and providers, and evaluating surveillance/third-party data.
  • We’ll empower you to learn and grow the career you want.

Matching Summary

Review LTC claims to identify fraud, waste, and abuse indicators using pattern recognition, documentation validation, and behavioral red flags.

Salary

Base: $73,350.00 USD - $122,250.00 USD; Bonus/Equity: Incentive programs and incentive compensation tied to business and individual performance; Benefits: Health, dental, mental health, vision, disability, life insurance, retirement savings plans, paid time off

Skills & Requirements

Must-have

  • LTC claims review
  • pattern recognition
  • investigative strategies
  • gather proof of payment
  • review medical information
  • prepare case summaries

Nice-to-have

  • sharp on details
  • energized by complex puzzles
  • comfortable turning ambiguity
  • problem-solving
  • weighing complex fact patterns

Key Requirements

  • 3+ years' experience in LTC claims
  • Bachelor's degree
  • insurance fraud/SIU/complex claims experience preferred
  • Bilingualism (English and French) is an asset

Work Rights

Not specified

Tailored Resume

Cover Letter