34 Results for

Claims Investigator Jobs in Cambridge, MA

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Boston, MAToday

The Manager ensures investigative quality, regulatory timeliness, and effective collaboration with law enforcement, internal stakeholders, and peer institutions while continuously strengthening fraud detection and prevention controls. This role provides strategic direction, operational oversight, and subject matter leadership across fraud investigations, SAR referral governance, regulatory adherence, and loss recovery efforts.

Foxborough, MA19 days ago

PHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.

Cambridge, MA15 days ago

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.

Boston, MA30+ days ago

Our Full-Time Entry-Level Field Investigator position will help launch your career by providing you with an industry leading FULLY PAID Investigator Training Program - no prior experience necessary! Documentation: Finalize case files by submitting case reports and uploading video footage via personal laptop at the end of the day.

Quincy, MA7 days ago

CoventBridge Group is a global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.

Nashua, NH30+ days ago

Allied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services' fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administration's (TSA) Third-Party Canine (3PK9) Program.

Manchester, NH30+ days ago

CoventBridge Group is the global leader in full-service investigations providing: Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs. The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.

Massachusetts9 days ago

Remote

That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Bridgewater, MA30+ days ago

Our leadership team brings over 25 years of field experience and is committed to fostering a professional, results-driven environment. Join Lemieux & Associates, a trusted leader in investigative services, and make an impact with your surveillance expertise.

Boston, MA30+ days ago

$89,508–$138,370 Per Year

Specialized Experience for the GS-12 level: One year of specialized experience equivalent to the GS-11 grade level or equivalent public or private sector experience that has equipped you with the particular knowledge, skills, and abilities to perform successfully the following duties or work assignments below: Conducting the full range of criminal investigations of greater than average complexity and importance using accepted methodology and problem-solving techniques. If you are claiming eligibility under the Veterans Employment Opportunities Act (VEOA), you must submit: A copy of your DD-214 that shows active service and character of discharge (member copy 4, Separated Members only) OR a certification of expected discharge or release from active duty under honorable conditions within 120 days from the date of application (Current Active Duty Members only).

MA30+ days ago

$46,988–$122,400 Per Year

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.

MA30 days ago

Remote

$73,350–$122,250 Per Year

Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We're looking for a detail-oriented, analytical LTC Fraud Investigator to help strengthen our Long-Term Care (LTC) Fraud, Waste & Abuse (FWA) program.

Work At Home, MA26 days ago

$66,330–$145,860 Per Year

The position plays a key role in identifying fraud risks, supporting program integrity efforts, and helping to prevent financial losses related to fraud, waste, and abuse. Directs complex investigations, including data analysis, interviews, and document review, to identify potential fraud, waste, and abuse, including NSA-related activity.

Waltham, MA7 days ago

Remote

$58,000–$90,000 Per Year

That's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Boston, MA30+ days ago

Achieve targets of investigative performance by identifying and addressing internal and external theft exposures; complete accident investigations and general liability claims reports. Drive Asset Protection excellence by facilitating selling process through consistent adherence to policies and procedures that safeguard customers, associates and company assets.

MA30+ days ago

$46,988–$112,200 Per Year

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes.

Boston, MA30+ days ago

Performs sophisticated analyses of large-scale hard-copy and electronic data such as health care claims data, financial transaction data, accounting records, or bank records to develop investigative leads and to determine their potential relevance to the allegations at issue. • Performs analysis to clarify the target suspects or organizations pattern of operations to identify information relevant to the legal issues involved and to recommend valuable approaches to the AUSAs or other members of the investigative team.

Marlborough, MA30+ days ago

Allied Universal Named to Forbes List of America's Best Employers by State IRVINE, Calif. Sept. 3, 2025 Allied Universal, the worlds leading security and facility services company, has been named to Forbes list of Americas Best Employers by State (2024), ranking in the top 100 for Arizona, Georgia, New Jersey and North Carolina. Allied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits.

Boston, MA30+ days ago

Driving Positions: must possess a valid Driver's License with at least one year of driving experience, a clean driving record (no major violations within last 36 months, no more than 1 accident in last 24 months, no more than one minor moving violation in last 24 months), a minimum level of insurance as required by Company policy, and the ability to safely operate a vehicle required. Allied Universal SkillBridge Program Allied Universal partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits.

Boston, MA30+ days ago

QUALIFICATIONS (MUST HAVE): Must possess one of the following: Bachelor's degree in Business, Marketing, Sales or related field of study with a minimum of five (5) years of outside sales experience, preferably within the government vertical Associate's degree in Business, Marketing, Sales or related field of study with a minimum of seven (7) years of outside sales experience, preferably within the government vertical High School diploma with a least fifteen (15) years of outside sales experience and including at least five (5) years within the government vertical Current driver's license if driving a company-owned vehicle Previous consultative sales experience Minimum of five (5) years of outside sales experience Ability to thrive in collaborating with operations partners and building relationships Skillful in consultative selling techniques with a record in achieving sales excellence (awards, top rankings, consistent goal achievement) Skilled at brand development using professional networks, local and national associations, and social media tools Outstanding interpersonal skills, oral and written, and adept in creating and delivering compelling presentations Proficient in web-based applications (e.g., Salesforce) and Microsoft Office programs Strong organizational skills to effectively plan cold calling, in person client meetings, reporting and goal achievement Ability to travel throughout all areas of the territory, including some overnight travel. RESPONSIBILITIES: Drive the entire sales process, including prospecting, management of self-generated and company provided leads, proposal development, contract and pricing negotiations, technical RFP responses, delivery of customized presentations and post close contract implementation Develop and execute strategic business development plans targeting state, local and federal government agencies, within a designated territory, to achieve company growth objectives, increased market share and positioning of Allied Universal's local presence and comprehensive solutions Build and maintain consultative relationships with government clients, industry partners, and stakeholders to foster long-term business partnerships Stay up to date on industry and market trends, competitive landscapes, and emerging technologies to identify innovative business opportunities Continuously assess and report on sales cycle activity, pipeline development and sales goal tracking through the use of the CRM tool and ongoing communication to senior management Collaborate with internal teams, including center of excellence departments (Finance and Marketing) as well as branch operational leadership to learn about the client's needs, position Allied Universal's comprehensive solutions and deliver a seamless transition of trust with the operational partner.

Boston, MA30+ days ago

Cambridge, MA30+ days ago

$206,250–$343,750 Per Year

The mission of this team is to support the company by functioning as the internal expert in rare hematologic conditions - focusing on recent launch in Immune Thrombocytopenia (ITP), and potentially including warm Autoimmune Hemolytic Anemia (wAIHA), and Sickle Cell Disease (SCD) among other rare blood disorders - and helping Health Care Professionals and Payers optimize patient care and treatment outcomes through evidence-based decisions. The Senior Medical Director will establish and maintain collaborative medical and scientific relationships with key external physicians and internal constituencies from multiple functional groups - including, but not limited to, Medical Affairs, Clinical Research, Regulatory, Science, Marketing, Sales, Commercial Operations, and Patient and Product Services - while maintaining full compliance with all relevant company, industry, legal, and regulatory requirements.

North Boston, MA24 days ago

$60,000–$117,700 Per Year

Appraisal Management, Appraisal Process, Appraisal Software, Automobile Maintenance, Automotive Maintenance, Automotive Repair, Automotive Service, Car Maintenance, CCC ONE, Cost Estimates, Damage Calculations, Insurance Adjusting, Insurance Appraisal, Insurance Valuation, Motor Vehicle Maintenance, Negotiation, Repair Estimating, Repair Services, Technical Repair, Writing. This role offers a sign on bonus of $1,000 if you have an active appraiser license or active adjuster license in TX, FL, or your resident state (current employees and candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus).

Somerville, Massachusetts26 days ago

The SIU team will perform accurate and reliable medical review audits, analyze medical billing and codes, conduct confidential investigations related to compliance and regulatory requirements, documenting the investigation through audit reports for interview and external review which document the findings, and reporting issues of non-compliance in accordance with all laws and regulations. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

Massachusetts10 days ago

Remote

Cambridge, MA30+ days ago

$170,000–$195,000 Per Year

Responsibilities: Contribute to the generation of aggregate safety reports including development safety update reports, periodic benefit risk evaluation reports, and provide medical input in review of new or existing safety documents to ensure compliance with relevant regulatory requirements, such as protocols, safety summaries and regulatory reports. The Role: Reporting to the Head of PV Science, the Associate Director, Drug Safety and Pharmacovigilance Scientist is responsible for assessing and interpreting safety data from multiple sources, including clinical trials, spontaneous and solicited reports, aggregate, and literature reports.

Boston, MA16 days ago

$95,000–$145,000 Per Year

Additional preferred qualifications include SAS Base and Advanced certification, hands-on experience working with SAS (Base, Stat, Macro, SQL), experience mentoring other statisticians and trainees in statistical methods, and expertise in at least one of the following areas: causal inference, longitudinal analysis, or weighting methods. Smith Center for Outcomes Research (bidmc.org)) is devoted to addressing the most pressing issues in cardiovascular care through innovative and rigorous analysis of diverse data sources, including large national registries, administrative claims data, survey-based data, and EHR data.

Waltham, MA7 days ago

Remote

$58,000–$90,000 Per Year

Somerville, MA30+ days ago

Experience: At least 5-7 years of experience in insurance audits, investigations, or a related field required At least 3-5 years of experience in a management role, preferably within healthcare required At least 5-6 years of experience in the Managed Care industry, Medicaid or Medicaid Managed care fraud detection unit preferred At least 6 years of experience in a health care payer setting and/or in a health care fraud control setting highly preferred. The SIU team will perform accurate and reliable medical review audits, analyze medical billing and codes, conduct confidential investigations related to compliance and regulatory requirements, documenting the investigation through audit reports for interview and external review which document the findings, and reporting issues of non-compliance in accordance with all laws and regulations.

MA30 days ago

Remote

$73,350–$122,250 Per Year

Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We're looking for a detail-oriented, analytical LTC Fraud Consultant to help strengthen our Long-Term Care (LTC) Fraud, Waste & Abuse (FWA) program.

Braintree, MA21 days ago

$146,000–$348,000 Per Year
Full-time

The salary ranges for this role are as follows: $146,000 - $348,000USD annually (Geographical Tier AA - Sample Locations: NY Metro, San Franscisco, San Jose, Seattle) $134,000 - $322,000 USD annually (Geographical Tier A - Sample Locations: Irvine CA, Middlesex NJ, Tacoma WA, Boston, Alexandria) $123,000 - $295,000 USD annually (Geographical Tier B - Sample Locations - Baltimore, Chicago, Anchorage, Portland) $112,000 - $268,000 USD annually (Geographical Tier C - Sample Locations - Atlanta, Charlotte, Cincinnati, Miami) $107,000 - $255,000 USD annually (Geographical Tier D - Sample Locations - Mississippi, Mobile AL, Bowling Green KY, Tulsa) Time away matters—so we provide a generous paid time off program, including vacation, sick time, and paid holidays (with prorated options for eligible part-time employees).At VERTEX, growth never stops. Analyze electrical systems including service equipment, switchgear, transformers, generators, motor controls, photovoltaic (PV) systems, battery energy storage systems (BESS), EV charging infrastructure, and industrial equipment.

MA19 days ago

$146,000–$348,000 Per Year

Analyze electrical systems including service equipment, switchgear, transformers, generators, motor controls, photovoltaic (PV) systems, battery energy storage systems (BESS), EV charging infrastructure, and industrial equipment. Perform root cause analyses involving electrical faults, arc events, equipment malfunctions, installation deficiencies, maintenance issues, operational errors, surge events, lightning damage, and utility disturbances.

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Claims Investigator Jobs in Cambridge, MA

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Government Business Development Manager Allied Universal

Security Site Supervisor Allied Universal

Security Shift Supervisor Pharma Allied Universal

US Senior Medical Director, Rare Hematology Sanofi

Field Auto Appraiser - North Boston, MA Allstate Insurance Company

Director, Special Investigations Unit Mass General Brigham

Senior Compliance Analyst, Special Investigations Unit Devoted Health Services

Associate Director, Drug Safety and Pharmacovigilance Scientist Nuvalent Inc

Lead Biostatistician (Interventional Cardiology and Vascular Research) Lahey Hospital and Medical Center

Senior Compliance Analyst, Special Investigations Unit Devoted Health Inc

Director, Special Investigations Unit Brigham and Women's Hospital

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Senior Electrical Forensic Engineer The Vertex Companies, LLC

Senior Electrical Forensic EngineerNEW The Vertex Co Inc

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