Fraud Consultant – LTC Fraud, Waste & Abuse
Manulife
full-time
Posted on:
Location Type: Remote
Location: Massachusetts • United States
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Salary
💰 $73,350 - $122,250 per year
About the role
- Review LTC claims to identify fraud, waste, and abuse indicators
- Manage a high-volume investigative caseload
- Conduct end-to-end investigations gathering various types of proof
- Monitor investigative trends and provide data-driven recommendations
- Prepare clear, evidence-based case summaries and well-documented investigative files
- Draft claimant communications and support escalations
Requirements
- Bachelor’s degree with 3+ years’ experience in LTC claims
- Strong knowledge of LTC products, processes, regulations, and systems
- Experience in insurance fraud/SIU/complex claims preferred
- Bilingualism (English and French) is an asset
- Proven ability to detect discrepancies across various types of data
- Superior written and verbal communication skills
- Strong critical thinking and execution skills
- Fraud credentials (e.g., CAMS, CFE, AHFI, FCLS) a plus
- Working knowledge of advanced analytics/AI and case management systems
Benefits
- Health insurance
- Dental coverage
- Mental health support
- Vision care
- Short- and long-term disability
- Life insurance
- Adoption/surrogacy benefits
- Wellness programs
- Employee/family assistance plans
- Retirement savings plans (401(k) with employer matching)
- Financial education and counseling resources
- Up to 11 paid holidays
- 3 personal days
- 150 hours of vacation
- 40 hours of sick time
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
LTC claimsinsurance fraudcomplex claimsdata analysisinvestigative techniquescase management systemsadvanced analyticsAI
Soft Skills
critical thinkingcommunication skillsattention to detailproblem-solvingorganizational skills
Certifications
CAMSCFEAHFIFCLS