Claims Processor I - Dental Claims (Remote) Job at Usaa in Las Vegas

Remote, USA Full-time
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. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. This role is remote eligible. There may be occasional business travel. Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims. Participates in the development of fraud prevention strategies. Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures. Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention. May serve as a resource team member on specific matters through demonstrated skill or training. Assists with the delivery of fraud awareness training initiatives in a defined environment. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. High School Diploma or General Equivalency Diploma (GED). ~2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience. ~ Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud. ~ Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems. ~ Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology. SIU experience conducting low to complex PNC fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience. US military experience through military service or a military spouse/domestic partner 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. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. 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. Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. 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. Apply tot his job
Apply Now

Similar Jobs

Medical Claims Processor job at Motion Recruitment in Denver, CO

Remote, USA Full-time

Claims Processing - Representative I

Remote, USA Full-time

Complex Claims Specialist (Remote)

Remote, USA Full-time

Transaction Processing, Claims Entry

Remote, USA Full-time

Remote Case Manager Job at The Firm Exp in San Francisco

Remote, USA Full-time

Case Manager I - SCMG Integrated Care Mgmnt - *Remote (San Diego Only) - Full Time - Days

Remote, USA Full-time

Clinical Case Manager Behavioral Health OhioRISE – Remote – OHIO

Remote, USA Full-time

Systems Admin/DBA (Secret Clearance) - DC Metro Area Remote / Telecommute Jobs

Remote, USA Full-time

Work From Home | Amazon | Data Entry | Customer Service

Remote, USA Full-time

Digital Marketing Manager, Amazon (Fully Remote)

Remote, USA Full-time

Tax Attorney – Real Estate/Affordable Housing

Remote, USA Full-time

Online Coding Teacher Remote 2026 , Part-Time (Must reside in US)

Remote, USA Full-time

Software Engineering Intern - statue.dev

Remote, USA Full-time

Customer Management – Distribution

Remote, USA Full-time

**Experienced Remote Data Entry Specialist – Part-Time Opportunity at blithequark**

Remote, USA Full-time

**Experienced Retail Sales and Customer Service Specialist – arenaflex Store Experience**

Remote, USA Full-time

Network Technician (Remote - 3RD Shift)

Remote, USA Full-time

Sales Executive - Business Development Specialist: Driving Growth in Education and Training

Remote, USA Full-time

Regulatory Data Analyst

Remote, USA Full-time

**Experienced Part-Time Remote Data Entry Clerk – Urgent Hire at blithequark**

Remote, USA Full-time
Back to Home