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Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.

ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront, we provide accurate data and actionable insights that translate into better decision-making for our clients. JOB SUMMARY:Our dynamic Ethos team is seeking an Experienced Field Investigator to conduct surveillance and investigative activities to identify potential fraudulent insurance claims. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients. KEY RESPONSIBILITIES:<ul><li>Case Preparation: Prepare for surveillance assignment by reviewing Ethos' preliminary reports and case information.</li><li>Field Surveillance: Perform covert surveillance from your vehicle by tracking and capturing high-quality video evidence of surveillance targets.</li><li>Report Writing: Draft detailed and court-ready investigative reports summarizing activity and key findings.</li><li>Documentation: Finalize case file by submitting case reports and uploading video footage via personal laptop at the end of the day.</li><li>Communication: Work closely with the field supervisor and operations teams, receiving regular guidance and mentorship.</li></ul> REQUIREMENTS:<ul><li>Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports.</li><li>Driver's License: Valid driver's license and proof of automobile insurance.</li><li>Personal Vehicle: A well-maintained vehicle that is always reliable (preferably with tinted windows).</li><li>Surveillance Equipment: A handheld camcorder with high-quality zoom and a covert camera device. Use of stabilization equipment (gimbals, tripods, etc.) is strongly encouraged.</li><li>Technology: A reliable laptop, cell phone, and internet service are needed for communication and administrative tasks.</li><li>Private Investigator License: Active Private Investigator license or willingness to obtain one (where required by state).</li></ul> WORKING CONDITIONS:<ul><li>While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be required</li><li>Most surveillance cases start at 6:00AM. End time can vary depending on activity and a typical workday can vary from 3-12 hours.</li><li>Weekends/holidays are common workdays as claimants are more likely to be active.</li><li>This is an independent role often requiring long hours alone in your vehicle, regardless of weather conditions.</li><li>Must remain alert with no external distractions, ready to use videography equipment to document subjects.</li></ul> Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic. A background check will be conducted, in accordance to the local state law and regulations. Job Posted by ApplicantPro

Ethos Risk Services

Investigator

Administrative Skills

Auto Insurance

Cellular Telephone

Driver's License

Insurance Claims

Internet/Online Service

Investigative Reports

Laptop PC

Mentoring

Mobile Devices

Operations Management

Organizational Skills

Reporting Skills

Risk

Surveillance

Willing to Travel

Talent Acquisition

Participate in surveys or complaint investigations to include allegations of abuse and neglect, and perform surveillance activities/tasks at nursing homes (long-term care) to determine compliance with Federal and State regulations. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals.

HOUR

Registered Nurse - Nursing Home Surveyor/Complaint Investigator - Albany, NY (#25316) Location: Albany, NY Employment Type: Full-time Hourly Rate: $50/hrAbout Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals.Position Overview: We are seeking an experienced Registered Nurse to conduct nursing home surveys and complaint investigations, ensuring compliance with federal and state regulations. This role involves travel to facilities, investigative work, and documentation to protect resident health and safety in long-term care settings.Why Join Us? <ul><li>Competitive Compensation: Earn $50 per hour</li><li>Comprehensive benefits: <ul><li>Sick leave</li><li>Flexible Schedule</li><li>This is a temporary-to-permanent position</li></ul></li><li>Work Schedule: Monday - Friday, Flexible Schedule (7:00 am - 7:00 pm) with required travel</li><li>Professional Growth: Gain specialized experience in healthcare regulation and compliance</li><li>Impactful Work: Contribute to quality improvement and resident safety in nursing homes</li></ul>Qualifications: <ul><li>Education: Nursing degree; Bachelor's in Nursing preferred</li><li>Licensure: Current New York State RN license</li><li>Experience:<ul><li>A minimum of two (2) years of experience in performing utilization review, claims adjudication, medical review, fraud investigation, surveillance or monitoring activities, required, OR</li><li>Three (3) years of clinical or administrative experience, required, OR</li><li>A Bachelor’s degree in nursing and two (2) years of clinical or administrative experience, required.</li><li>SMQT Certification, preferred.</li></ul></li><li>Other Requirements: <ul><li>Strong interpersonal skills with the ability to facilitate positive customer satisfaction in situations that are adverse or in controversy.</li><li>Ability to successfully work independently with minimal supervision, as well as in a team environment.</li><li>Excellent communication (written and verbal) skills with the ability to relate effectively to providers, physicians, senior medical and administrative personnel, and residents/patients.</li><li>Superior investigative and analytical skills with a proficiency in conducting interviews with facility staff, residents, and families.</li><li>Strong computer skills with the ability to learn new programs.</li><li>Ability to obtain Surveyor Minimum Qualifications Test (SMQT) certification within 12 months of employment, required.</li><li>Ability to travel to onsite location.</li></ul></li></ul>Responsibilities: <ul><li>Participate in surveys or complaint investigations to include allegations of abuse and neglect, and perform surveillance activities/tasks at nursing homes (long-term care) to determine compliance with Federal and State regulations.</li><li>Produce written documentation and draft a Statement of Deficiencies (SOD) within the required time frame, using Principles of Documentation.</li><li>Assess compliance with the Plan of Correction within the required time frame.</li><li>Complete data entry in Federal and State reporting databases as required.</li><li>Participate in State monitoring during Immediate Jeopardy situations.</li><li>Attend meetings as required.</li><li>Testify in administrative hearings as needed.</li><li>Adhere to DOH work schedules.</li><li>Adhere to DOH and IPRO policies and procedures.</li><li>Travel to onsite locations according to work schedule</li></ul>How to Apply: If you are an experienced RN with a regulatory/compliance background ready to make a difference in nursing home quality, we want to hear from you! Submit your Resume/CV to hr@glhstaffing.com or call our office at (800) 608-4025 to learn more about this opportunity.Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives

GreenLife Healthcare Staffing

Registered Nurse - Nursing Home Surveyor/Complaint Investigator

Adjudication

Analysis Skills

Communication Skills

Computer Skills

Customer Satisfaction

Data Entry

Documentation

Federal Laws and Regulations

Fraud Investigation

Healthcare

Interpersonal Skills

Interviewing Skills

Long-Term Care

Maintain Compliance

Nursing

Nursing Home

Presentation/Verbal Skills

Quality Management

Recruiting/Staffing Agency

Registered Nurse (RN)

Regulatory Compliance

Safety/Work Safety

State Laws and Regulations

Utilization Management

Writing Skills

Crelate

ADAPTED_NOW

We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.

YEAR

Investigator Assistant Supports the Payment Integrity line of business Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Investigator Assistant is responsible for providing administrative support to the investigative unit and performing research on data to assist in identifying cases of potential overpayment or abuse. How you will make an impact: + Collects, researches, and validates bills and claims data against relevant guidelines. + Assists in preparation of statistical and financial analysis reports. + Requests medical records and additional documentation required for investigation. + Completes initial file set-up and tracks cases. + Processes and tracks all incoming reimbursement checks. + Assists in managing fraud hotline calls. + Provides administrative support for investigative management and staff. Minimum Requirements + Requires a HS diploma or equivalent and minimum of 1 year experience; or any combination of education and experience, which would provide an equivalent background. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $41,911 to $68,866. Locations: District of Columbia (Washington, DC) Maryland and New York. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Elevance Health

Investigator Assistant

Gap Inc.

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