Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:Highly competitive total rewards …
Skills: Fraud investigation, Data analytics, Risk assessment, Claims auditing, Medical terminology
Why Redmond? We’re a best-in-class general contractor driven by a passion for transforming spaces and providing top tier service to our clients. Named one of Crain’s Best Places to Work five years running, our team consi…
Skills: Project Management, Data Center Construction, MEP Systems, Critical Infrastructure, Commissioning
Commerce Bank
Senior Manager, Product Management - Healthcare
Kansas City, Missouri, United States · Hybrid
$158k–$188k/yr
Senior+$150M raised
About Working at Commerce Building a career here is more than just steps on a ladder. It’s about helping people find financial safety and success, helping businesses thrive, and making sure people and their money are tak…
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government pr…
Skills: Customer service, Problem solving, Active listening, Communication skills, Time management
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government pr…
Skills: Customer service, Communication, Problem solving, Active listening, Empathy
As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare …
Skills: Financial reconciliation, Banking systems, Wire transfers, Excel, Quality control
As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare …
Financial/Operational Auditor, Senior (Kansas City, MO area)
Kansas City, Missouri, United States · On-site
Senior
Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:Highly competitive total rewards …
UMB Information Technology organization is comprised of IT leaders, project managers, architects, software engineers, and analysts coming from diverse background and experiences. We share a strong commitment to ensure ou…
Who we are looking for In the Fund Accounting, Senior Associate role, you will deliver highly valued services to clients to ensure quality services are consistently delivered and clients are offered State Street’s full r…
Skills: Fund accounting, Analytical skills, Problem-solving, Detail oriented, Deadline driven
About HUB: HUB International is a global insurance broker providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. HUB ha…
As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare …
Sign-On Bonus Opportunity of up to $1,000* Pay Range: $40000 - $50000 / year Our Perks: Unlimited/Uncapped commission Lucrative incentive sales plans, bonuses and sales contests No Cold Calling- We have a high volume of …
Sign-On Bonus Opportunity of up to $1,000* Pay Range: $40000 - $50000 / year Our Perks: Unlimited/Uncapped commission Lucrative incentive sales plans, bonuses and sales contests No Cold Calling- We have a high volume of …
Sales Internship Program Location: Oakes GMC | Kansas City, MO Schedule: Full-Time | Monday - Friday Compensation: $18 an hour About the Role The Sales Internship Program is a hands-on rotational internship designed to g…
Skills: Sales, Customer communication, Vehicle presentations, Test drives, CRM systems
Company Description Village Green Future Growth Class A Property Manager | Kansas City, MO Pay: $65k to $70k, plus bonus & commission potential +$18k Growth Opportunity Founded in 1919, Village Green is a diverse, people…
The Sales Administration Representative I supports the sales team by handling day-to-day data entry, documentation, and administrative activities that keep equipment records accurate and operations running smoothly. This…
Skills: Data entry, Inventory management, Administrative support, Microsoft Outlook, Microsoft Office
Customer Service Representative - State Farm Agent Team Member
Kansas City, Missouri, United States · On-site
$40k–$50k/yr
Entry level
Benefits: Health insurance Opportunity for advancement Paid time off Training & development 401(k) Bonus based on performance Competitive salary Flexible schedule ROLE DESCRIPTION: As a Customer Service Representative wi…
VP, Commercial Real Estate Senior Relationship Manager Our mission is to create exceptional experiences for our customers that help them achieve their dreams, and we seek extraordinary individuals with the talent and pas…
Skills: Commercial real estate lending, Portfolio management, Credit structuring, Financial analysis, Business development
The Fraud Investigator conducts reviews to identify potential fraud, waste, and abuse within healthcare claims. They are responsible for maintaining detailed case files, preparing investigative reports, and coordinating with internal and external stakeholders.
Requirements
Candidates must hold a bachelor's degree in a relevant field and possess at least one year of investigative experience. Preferred qualifications include a master's degree, three years of healthcare fraud investigation experience, and relevant professional certifications.
Full job description
Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:
Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
Annual incentive bonus plan based on company achievement of goals
Time away from work including paid holidays, paid time off and volunteer time off
Professional development courses, mentorship opportunities, and tuition reimbursement program
Paid parental leave and adoption leave with adoption financial assistance
Employee discount program
Job Description Summary:
As part of Blue KC’s Special Investigations Unit (SIU), the Fraud Investigator conducts reviews to identify potential fraud, waste, and abuse (FWA) and claim overpayments. Assigned cases and projects are generally of moderate complexity and performed with limited oversight.
Job Description
Assist in performing ongoing FWA risk assessments, leveraging data analytics to identify trends, patterns, outliers relative to peers and clinical standards, etc. In conjunction with the Manager and/or Senior Investigator, evaluate FWA risks and prioritize for further review, based upon member health/safety and protection of plan assets.
Monitor hotlines, internal referrals, external fraud alerts (e.g., CMS, BCBSA), external healthcare anti-fraud workgroups, and other resources for potential FWA schemes.
Conduct investigations of fraud, waste and abuse in accordance with SIU policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations.
Create and maintain detailed case files in accordance with SIU policies and procedures, where key investigative activities and outcomes are timely and accurately documented
Prepare detailed case reports summarizing investigative findings and recommendations. Present reports to key stakeholders (e.g., Provider Relations, Medical Management, Pharmacy, Claims, Legal)
Assist in coordinating responses to subpoenas and preparation of cases for referral to law enforcement and/or regulators.
Perform day-to-day activities for vendor-based claim overpayment recovery program (e.g., data file exchanges, proposing / reviewing new audit concepts, coordinating claim adjustments, invoices).
Assist in preparing reports for executive updates, Blue KC Audit Committee, BCBSA/FEP surveys, and other reports as needed.
Support the FWA training program for Blue KC employees and First Tier, Downstream and Related entities.
Minimum Qualifications
Bachelor’s degree in criminal justice, finance, accounting, medical or other relevant academic discipline. 1 years investigative experience in the following areas (e.g., medical review, financial, medical analytics, behavioral health, research & adjustment, appeals) that provided the types and levels of knowledge, skills, and abilities required.
Strong communication skills with a broad range of individuals and groups (e.g., members, providers, operational areas, medical directors, provider relations, legal counsel, senior management)
Preferred Qualifications
Master’s degree in criminal justice, finance, accounting, medical or other relevant academic discipline
3 years' experience conducting healthcare FWA investigations at a health insurer; experience analyzing claims data to identify FWA trends and patterns using tools such as Excel and business intelligence platforms (e.g., Power BI, Business Objects).
Knowledge of major BCBSKC business systems (e.g., Facets, ITS Host and Home) and operational processes (e.g., Claims Processing, Pharmacy, Provider Contracting/Relations, Member Services, Customer Service)
Knowledge of BCBSKC provider contracts, medical policies and member benefits
Knowledge of medical terminology and ICD/CPT coding
Experience working with the regulators (e.g., CMS, State Department of Insurance) and law enforcement (e.g., FBI, DEA, HHS-OIG, OPM-OIG and/or Department of Justice)
Blue Cross and Blue Shield of Kansas City is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.
Blue Cross and Blue Shield of Kansas City (Blue KC) is an independent licensee of the Blue Cross Blue Shield Association and a not-for-profit health insurance provider serving more than one million members in 32 counties in greater Kansas City and northwest Missouri and Johnson and Wyandotte counties in Kansas.
Blue KC's mission is to provide affordable access to healthcare and to improve the health of our members.
Blue KC was named one of the “Best Companies to Work For” in 2012 and 2019 in the large company category by Ingram’s Magazine.
Offices: 1400 Baltimore Ave, Kansas City, Missouri 64105, US
How many Finance & Accounting jobs are open in Kansas City, MO right now?
There are currently 633 open finance & accounting positions in Kansas City, MO listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Kansas City, MO?
Companies currently hiring include Lockton, UMB Bank, Commerce Bank, H&R Block, RubinBrown LLP, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Kansas City, MO?
Yes — 234 of the 633 open finance & accounting positions offer remote or hybrid work (61 remote, 173 hybrid).
How do I apply for Finance & Accounting jobs in Kansas City, MO?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.